支气管哮喘并发幽门螺杆菌感染患儿粪便抗原与血清抗体特征分析

目的了解支气管哮喘(哮喘)并发幽门螺杆菌感染患儿幽门 螺杆茵(HP)感染情况、免疫表型及其血清型的分布特征。方法收集 2016年12月～2017年12月支气管哮喘患儿与同龄健康体检儿童的14C-BUT检测结果， 并收集两组人群的粪便与血清样本，分别采用粪便HP抗原和血清HP抗体检测，比较其与 14C-BUT对于儿童HP感染检测结果之间的差异；采用三种HP诊断方法(14C-BUT， 粪便HP抗原，血清HP抗体检测)筛查两组HP感染，比较各组间HP感染的阳性率是否存在差异 ；另外，对血清HP抗体阳性的哮喘和健康体检儿童，进一步采用HP血清抗体谱进行分析，以 了解哮喘并发HP感染儿童HP血清抗体谱的分布，并比较分析两组间抗体谱及血清型分布差异 。结果通过在哮喘和健康体检儿童中三种HP诊断方法比较，三者间 的差异无统计学意义( χ2=1.06，0.77，0.72，均P >0.05)，在支气管哮喘与健康 体检儿童中HP感染率分别为:30.4%~32.6%和35.4%~37.4%，两组间差异无统计学意义( P >0.05)，HP抗体阳性哮喘患儿和健康体检儿童中各抗体谱阳性率为:抗VacA-95KD(3 1.8%，50.9%)，VacA-91KD (31.8%，50.9%)，UreA-66KD(65.9%，54.5%)，UreB-3 0KD(63.6%，52.7%)，其抗体的阳性率在两组之间差异无统计学意义( χ2=3.64，3. 64，1.31，1.19，均P >0.05)；仅CagA-116 KD抗体阳性率(36.4%，56.4%)在两组间 差异具有统计学意义( χ2=3.92，P ＜0．05)。另外I型和Ⅱ型HP感染率在两组中的百 分比分别为:哮喘组Ⅰ型36.4%(16/44)和Ⅱ型63.6%(28/44)，健康体检组Ⅰ型56.4%(31/ 55)和Ⅱ型43.6%(31/55)，两组间差异存在统计学意义( χ2=3.92，P <0.05)。〖HT 5结论哮喘的发病率与HP的感染率无直接联系，但其与抗-CagA抗体的阳 性率存在明显的负相关，且具有特定的血清型和抗体谱分布特征，这为我们进一步研究哮喘 与HP感染的内在联系奠定了理论基础。

Characteristics of Stool Antigen and Serum Antibody in Children with Bronchial Asthma and Helicobacter Pylori Infection

Objective To investigate the distribution of Helicobacter pylori (HP) infection，immunophenotype and serotype in children w ith bronchial asthma and Helicobacter pylori infection．Methods From December 2016 to December 2017，the results of 14C-BUT te st in bronchial patients and healthy children of the same age were collected，an d the stool and serum samples of the two groups were collected．Stool HP antigen and serum HP antibody were used to detect by the different ways，and compared w ith the results of 14C-BUT test in children．In order to，understand the distribution of HP serum antibody spectrum in children，and to study the differe nce of antibody spectrum and serotype distribution between the two groups． Results There were no significant difference among the three d iagnostic methods of HP ( χ 2=1.06，0.77，0.72，all P >0.05)．The in fection rates of　HP were 30.4%~32.6% and 35.4%~37.4% in children with bronc hial asthma and healthy children，respectively．There was no significant differe nce between the two groups ( P >0.05)．The positive rates of anti-VacA-95KD (31.8%，50.9%)，VacA-91 KD (31.8%，50.9%)，UreA-66KD (65.9%，54.5%) and UreB-30KD (63.6%，52.7%) were not significantly different between the two gr oups ( χ 2=3.64，3.64，1.31，1.19，all P >0.05)．The positive rates of CagA-116KD antibody (36.4%，56.4%) were significantly different between t he two groups ( χ2=3.92，P ＜0.05)．The infection rates of HP type I and Ⅱ were 36.4% (16/44) and 63.6% (28/44) in asthma group，56.4% (31/55) in phy sical examination group and 43.6% (31/55) in health examination group，respecti vely．There was significant　difference between the two groups ( χ2=3.92，P <0.05)．Conclusion The incidence of bronchial asthma i s not directly related to the infection rate of HP，but it is negatively correla ted with the positive rate of anti-CagA body， and has specific serotype and an tibody spectrum distribution characteristics，which lays a theoretical foundatio n for further study of the relationship between bronchial asthma and HP infectio n．