| Objective: Aim to explore the effect of Helicobacter pylori(HP)infection on the clinical manifestation(renal involvement,abdominal pain,vomiting,gastrointestinal hemorrhage,joint symptoms,rashes.et)of Henoch-Schonlein purpura(HSP)in children.Methods: Children diagnosed with HSP in Children’s Hospital of Chongqing Medical University from January 2016 to December 2017,and also with inspection result of HP(13C-UBT 、 R-UT and biopsy).According to the infection of Helicobacter pylori(HP),these children with HSP were divided into two groups: HP(+)and HP(-)group and the differences in clinical data were evaluated by statistic analysis between two groups.Results: There were 173 children with HSP enrolled totally.1.Clinical manifestation:(1)Hemorrhage of digestive tract: 73/173 children get different degrees of gastro-intestinal hemorrhage in total,28/43(65.1%)case in HP(+)group and 45/130 in HP(-)group,The incidence of gastrointestinal hemorrhage was significantly different between the two groups whether regard of age and sex or not(P<0.05).(2)Kidney damage:61/173 case were kidney damaged in total,23/43(53.5%)cases in HP(+)group and 38/130(29.2%)in HP(-)group.The incidence of kidney damage was significantly different between the two groups whether regard of age and sex or not(P<0.05).However,there is no significant difference in other clinical manifestations of the two groups,such as vomiting,abdominal pain,rash,joint swelling and pain,no matter we regard the influence of age and sex or not(P>0.05).2.Imaging examination: 12/43 intestinal wall thickening and 10/43 peritoneal effusion in HP(+)group,45/130 intestinal wall thickening and 32/130 peritoneal effusion of HP(-)group,There was no statistical difference in the above imaging findings between the two groups(P>0.05).3.Endoscopy: In HP(+)group,there were 22 cases with hyperemia and edema,only 1case with forgrainy edema and ulcer,21 cases with mucosas erosions;In HP(-)group there were 68 cases with hyperemia and edema,50 cases with erosion,4cases with ulcers.Hyperemia and edema was widely distribution in sinuses ventriculi,fundus ventriculi and corpora ventriculi in both two groups.But mucosal erosions mainly appeared in duodenal bulb [HP(+)13/50 cases and HP(-)31/50 cases,respectively].And followed is sinuses ventriculi [HP(+)5/50 cases and HP(-)10/50 cases].The ulcer of HP(+)group appeared in duodenal bulb while HP(-)as following: There were 3 cases with duodenal bulb,1case with corpora ventriculi and 1 caes with sinuses ventriculi.4.Gastric and duodenal mucosal biopsy: A total of 28/173 cases were contained.All ofthem were treated with dipyridamole during hospitalization.13/43 cases(5cases with gastric mucosa and 8 with duodenal mucosa)in HP(+)group and 15 /130 cases(11 cases with gastric mucosa and 4 cases with duodenal mucosa)in HP(-)group.The main lesions types include neutrophil infiltration,eosinophilic granulocyte infiltration,platelet thrombosis,vasculitis and vascular wall necrosis.Conclusion: 1.HP infection might contribute to renal injury and increase the risk of hemorrhage of digestive tract in children with HSP.2.Recommendation: For HSP children with HP infection,suitable therapeutic schedule for active anti HP therapy.3.Owing to the size of the sample and the limitations of the territory in this study,it is not certain whether HP infection increases the risk of other symptoms such as vomiting,abdominal pain,joint swelling and rash or not.A further large sample of multicenter clinical investigation is necessary to verify it. |
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