Relationship Between Subtype Of H.pylori And Henoch-Schonlein Purpura In Children

Purpose:Research the relationship between Helicobacter Pylori typing and children Henoch-Schoenlein Purpura.Methods:Select 70 children with Henoch-Schonlein purpura were in accordance with the diagnostic criteria of Henoch-Schonlein purpura in the 7th edition of "Zhu Futang TextBook of Pediatrics" and the other 30 healthy children as the control group,all were treated in the China-Japan union hospital of Jilin University from April 2015 to April 2017.All the children were taken blood sample and tested with HP antibody typing test kit.44 patients with varying degrees of abdominal pain accompanied by nausea,vomiting,gastrointestinal bleeding and other symptoms were taken samples with gastroscope biopsy.According to the results of HP typing test: CagA band and / or VacA band were identified as type I HP infection;no Cag A band and VacA region were identified as type II HP infection;without Cag A,VacA and Ureas band were identified as negative for HP infection.The HSP children infected with HP were randomized into two groups,one group was given conventional treatment(NSAIDs,adrenocortical hormone)marked as control group;the other group in addition to conventional therapy was treated with anti-HP treatment(omeprazole 0.8-1mg /(kg·d),once a day,amoxicillin 50 mg /(kg·d)twice daily,clindamycin 15-20 mg /(kg·d)twice daily)marked as the treatment group.All children were treated for 2 weeks.We count the improvement rate after two weeks of treatment and follow up the recurrence rate.All data was calculated using SPSS 24 with T test to determine whether there is statistical difference between the data.Results:(1)Among the 70 cases of HSP,44 were HP positive,including 36 males and 34 females,with an average of 8.9 ± 3.1 years old.The HP infection rate was 62.9%.In the 30 healthy controls,11 were HP positive,including 18 males and 12 females,averaged 9.4 ± 3.4 years old and the HP infection rate was 36.7%.There was no significant difference in gender and age between the two groups(p> 0.05).There was significant difference in HP infection rate between the two groups(p <0.05).(2)In 70 HSP cases,44 were accompanied with varying degrees of gastrointestinal symptoms,among which 42 were HP-positive and the infection rate was 95.5%.The other 26 patients had negative gastrointestinal symptoms and 2 were HP positive,the infection rate was 7.7%.There was significant difference in the infection rate(p <0.05).(3)In 44 cases of HP-positive HSP children,42 cases were Henoch type.40/42 cases were infected by type I HP and the infection rate was 95.2%;2 cases were not Henoch type,0/2 was infected by type I HP and the infection rate was 0%.There was significant difference in the infection rate of type I HP(p <0.05).(4)In 44 cases of HSP with varying degrees of abdominal symptoms,40 were infected by HP among which 33 were infected by typeⅠHP and underwent endoscopy,the mucosal injury rate was 82.5%.2 cases were infected by type II HP and no evidence of mucosal injury was found.There was significant difference in the infection rate of mucosal injury(p <0.05).(5)After anti-HP therapy,in treatment group the effective rate was 90.9% and the recurrence rate was 9.1%.In control group the effective rate was 68.2% and the recurrence rate was 22.73%.The difference between the two groups was statistically significant(p <0.05).Conclusion:HP infection is correlated with the incidence of HSP,and type I HP infection more likely to cause abdominal allergic purpura.Type I HP infection is more likely to cause gastric mucosal injury.For HP-positive children with HSP using anti-HP treatment can effectively raise the improvement rate,and reduce the recurrence rate.