免疫球蛋白A1和肝细胞生长因子与腹型过敏性紫癜患儿胃组织损伤关系的研究

目的探讨IgAl和肝细胞生长因子（HGF）在腹型过敏性紫癜（I-1SP）患儿胃肠道损伤中的作用。方法取临床有持续或反复腹痛的腹型HSP患儿胃黏膜组织的病例为腹型HSP组，取胃镜检查明确诊断为急性胃炎患儿胃黏膜组织的病例为非HSP胃炎组；取胃肿瘤患儿切除部分胃的远离肿瘤部分、并经病理证实为正常胃黏膜组织的病例为正常对照组。运用免疫组织化学非生物素二步法检测IgA、IgAl和HGF蛋白在各组胃黏膜组织中的表达情况。结果腹型HSP组20例，非HSP胃炎10例，正常对照组4例。①腹型HSP组胃黏膜组织IgA、IgAl蛋白主要表达于胃黏膜上皮的表面黏液细胞内和固有层管状腺间的间质细胞、炎症细胞内；其免疫分数显著高于非HSP胃炎组和正常对照组，IgA蛋白：（0．61±0．02）vs（0．55±0．04）和（0．14±0．03），IgAl蛋白：（0．58±0．05）vs（0．38±0．03）和（0．13±0．05）；腹型HSP组IgAl／IgA免疫分数比值（0．94±0．02）亦显著高于非HSP胃炎组（0．69±0．06）；②腹型HSP组胃黏膜组织中HGF蛋白主要表达于胃黏膜固有层的管状腺细胞内，其免疫分数显著高于非HSP胃炎组和正常对照组，（0．16±0．03）vs（0．39±0．08）和（0．50±0．01），差异有统计学意义；③腹型HSP组胃黏膜组织中IgAl与HGF蛋白的表达水平呈正相关（r=0．892，P〈0．01）。结论对于无典型皮疹的腹型HSP患儿，IgA!及HGF可能作为病理学指标对HSP诊断及鉴别提供新的依据。

Study on the relation between IgAl and hepatocyte growth factor with gastric mucosa injury in children with Henoch-Schonlein purpura

Objective To investigate the expression of IgAl and hepatocyte growth factor（HGF） in gastric mucosa of children with Henfich-Schonlein purpura （HSP） and its effect on the gastric mucosa injury of HSP, and to provide a new foundation for clinical diagnosis. Methods Twenty gastric mucosa specimens of HSP children with persistent or recurrent abdominal pain were collected （HSP group）. IgA1 and HGF protein expressions in gastric mucosa of HSP group, non-HSP gastritis group （n = 10） and control group（ n = 4） were detected with immunohistochemistry method. Results ①In HSP group, IgA, IgAl protein expressed in the surface mucous cells of gastric mucosa, mesenchymal ceils, inflammatory cells of lamina propria, they（0.61 ± 0.02,0.58 ± 0. 05） were significantly higher than the non-HSP gastritis group（0. 55 ±0. 04,0.38 ±0.05） and the control group（0.14 ±0.03, 0.13 ±0. 05 ）, meanwhile IgAl/IgA （ O. 94 ± 0. 02 ） was also higher than that in non-HSP gastritis group （ 0. 69 ± 0. 06 ） （ P 〈 0. 01 ） ;②HGF protein expressed in tubular gland cells of lamina propria, it（0. 50 ± 0. 01 ） was also higher than that in non-HSP gastritis group（0. 39 ±0.08） and the control group （0. 16 ±0. 03） （P 〈0. 01 ）. ③The expression of IgAl in gastric mucosa was positively correlated with the expression of HGF（r =0. 892, P 〈 0.01 ）. Conclusion ①IgA, IgAl and HGF were expressed on gastric mucosa of HSP , and the expressions of IgAl and HGF were positively correlated. Prompting aberrant glycosylation of lgAl deposited is the main reason causing pathological damage, and I-IGF may play an antagonistic role to IgAl. ②IgAl and HGF may be the new pathological indicators for diagnosis in no-rash HSP children.