幽门螺杆菌相关过敏性紫癜

自 198 2年Warren和Marshall成功地从胃粘膜分离出幽门螺杆菌 (helicobacterpylori,以下简作Hp)以来 ,随着研究的不断深入 ,目前已确定该菌与慢性胃炎、消化性溃疡、胃癌、粘膜相关淋巴样组织淋巴瘤密切相关 ,1994年WHO将其列为第一类生物致癌因子。近年来 ,研究已涉及Hp与胃肠外疾病的关系 ,包括 :冠状动脉粥样硬化性心脏病、高血压、脑血管病、偏头痛、原发雷诺现象、干燥综合征、自身免疫性血小板减少性紫癜、过敏性紫癜、自身免疫性甲状腺炎、糖尿病、慢性荨麻疹、酒糟鼻等[1] 。本文将专题报告幽门螺杆菌相关过敏性紫癜。幽门螺杆菌…     

地区差异与老年人幽门螺杆菌感染的相关性

目的了解北京地区老年人群中幽门螺杆菌（Hp）的感染状况和地区差异。方法采用随机抽样人户问卷调查的方法，调查北京不同地区（城区、郊区、山区）60岁及以上的老人2006例，应用免疫印迹法检测血清Hp-IgG抗体。结果山区老人Hp的感染率为91．1％。城区为82．6％，郊区为77．2％，山区明显高于城区和郊区（P〈0．001）。结论北京城区、郊区和山区老年人群中的Hp感染率存在着显著差异，但地理因素不是决定性因素。     

腹型过敏性紫癜患儿幽门螺杆菌感染与消化道出血的关系及相关因素探讨

目的 探究腹型过敏性紫癜(HSP)患儿幽门螺杆菌(H. pylori)感染与消化道出血的关系及相关因素。方法 回顾性选取2017年3月至2020年3月辽宁省健康产业集团阜新矿总医院儿科收治的102例腹型HSP患儿并分为消化道出血组(n=104)和非消化道出血组n=128),对比两组H. pylori感染情况及H. pylori分型、肠道菌群、炎症细胞因子、T淋巴细胞亚群水平。结果 消化道出血组的Ⅰ型H. pylori感染率高于非消化道出血组(P<0.05);消化道出血组的乳酸杆菌、双歧杆菌数量及外周血CD4⁺、CD4⁺/CD8⁺水平低于非消化道出血组,大肠杆菌数量及血清白介素-6(IL-6)、IL-8、肿瘤坏死因子-α(TNF-α)水平均高于非消化道出血组(P<0.05)。经Logistic回归分析,Ⅰ型HP感染、双歧杆菌数量、血清TNF-α水平、外周血CD4⁺及CD4⁺/CD8⁺水平是腹型HSP患儿发生消化道出血的影响因素(P均<0.0...     

幽门螺杆菌感染的分型诊断与临床治疗

目的：探讨免疫印迹法幽门螺杆菌分型诊断与不同上消化道疾病以及抗幽门螺杆菌的治疗疗效的关系。方法：应用免疫印迹和^14C呼气试验观察了来我院就诊的Ⅰ型和Ⅱ型幽门螺杆菌现症感染者中胃炎、消化性溃疡和胃癌构成比以及三联抗幽门螺杆菌治疗根除率。结果：Ⅰ型幽门螺杆菌现症感染者中消化性溃疡和胃癌的构成比显著高于Ⅱ型（P＜0．001）。三联治疗对Ⅰ型与Ⅱ型幽门螺杆菌的根除率相似（分别为81．5％和85．7％,P＞0．05）。结论：应用免疫印迹法进行幽门螺杆菌分型诊断有利于临床对上消化道病情的判断,Ⅰ型感染可能更有治疗的必要性,三联治疗对Ⅰ型和Ⅱ型幽门螺杆菌均有较好的效果。     

分析不同年龄儿童胃泌素水平与幽门螺杆菌感染相关性研究

目的:探讨不同年龄儿童胃泌素水平与幽门螺杆菌(Hp)感染相关性及其调控的分子机制。方法:收集3～25 d、6个月～2岁、3～6岁幼儿血清,采用ELISA检测血清胃泌素水平,通过口服或肛门感染建立小鼠Hp感染模型,采用ELISA检测小鼠血清及胃泌素水平,并给予实验组小鼠p38抑制剂SB203580处理,采用Western Blotting检测不同分组小鼠Gas、ERK、p38、JNK1蛋白表达水平。结果:儿童血清中胃泌素水平与年龄无相关性,Hp感染阳性儿童血清胃泌素水平显著高于Hp感染阴性儿童(P<0.05)。口服组及肛门组小鼠血清胃泌素水平明显高于对照组,差异有统计学意义(P<0.05),口服组及肛门组小鼠血清胃泌素水平比较差异无统计学意义(P>0.05),口服组及肛门组小鼠胃组织中Gas、ERK、p38、JNK1蛋白表达显著高于对照组(P<0.05),而给予p38抑制剂SB203580后,Gas、ERK、p38、JNK1蛋白表达水平显著低于未给药处理的口服组及肛门组(P<0.05)。结论:年龄对儿童胃泌素水平影响可能不大,Hp通过MAPK信号通路调控胃泌...     

幽门螺杆菌感染儿童血清锌检测的临床意义

目的观察和分析幽门螺杆菌（Hp）感染儿童血清锌水平。方法测定30例Hp感染儿童血清锌水平,以同期30例Hp检测阴性健康儿童为对照组,比较两组血清锌水平。结果与对照组比较,Hp感染组儿童血清锌水平明显下降（P〈0.05）。结论 Hp感染与锌缺乏互为因果,对Hp感染儿童不仅应行血清锌检测,而且常规补锌治疗,亦是重要且必要的。     

胃息肉的类型与幽门螺杆菌感染相关性研究

目的探讨不同病理类型胃息肉幽门螺杆菌(Hp)感染率的差别。方法收集5年来我院门诊及住院患者18899例,所有患者均经胃镜检查及快速尿素酶,14碳呼气实验检查。统计不同病理类型胃息肉的Hp感染情况。结果其中胃息肉患者250例,Hp感染率64.0%,增生性息肉中145/215例Hp为阳性,胃底腺息肉中15/35例Hp为阳性,统计学显示增生性息肉与胃底腺息肉Hp感染率有统计学差异(P<0.05)。结论增生性息肉与Hp关系较胃底腺息肉密切,其Hp感染率显著高于胃底腺息肉。     

幽门螺杆菌感染与儿童支气管哮喘发病的相关性研究

目的探讨幽门螺杆菌(Helicobacter pylori,H.pylori)感染与儿童支气管哮喘发病的关系。方法采用14C呼气试验检测H.pylori感染,比较H.pylori感染儿童与正常儿童之间的哮喘发病率和病情发展情况。结果 H.pylori感染儿童哮喘发病率较正常儿童低(6.33%vs 12.66%,P0.05);H.pylori阳性的哮喘儿童较H.pylori阴性的哮喘儿童拥有更长的缓解期(P0.05)。结论H.pylori感染与儿童哮喘的发病和复发呈负相关,具体机制有待进一步研究。     

幽门螺杆菌感染与成人特发性血小板减少性紫癜

本文简述了幽门螺杆菌(Hp)感染的特点、致特发性血小板减少性紫癜的机理以及根除Hp的临床意义,从而提示Hp与胃肠外疾病的关系应予关注。     

Helicobacter pylori infection in children

Helicobacter pylori is an established cause of chronic-active gastritis in both adults and children. However, it is unclear whetherH. pylori causes specific clinical symptoms. Therefore, the spectrum of clinical symptoms associated withH. pylori infection was studied in consecutive symptomatic children undergoing diagnostic endoscopy at two pediatric centers, using a structured questionnaire. In Toronto, Canada, 86 of 97 eligible children were enrolled into the study and in Limerick, Ireland, 24 of 29 were enrolled. The frequency of biopsy-confirmedH. pylori infection in Limerick, 16 of 24 (67%), was fivefold higher than in Toronto, 11 of 86 (13%,P=0.0001). The two study populations were comparable in clinical presentation and duration of symptomatology and did not differ in age (11.9±3.5 and 11.6±2.0 years, respectively). Within both study populationsH. pylori infection was not associated with specific clinical symptomatology, including duration of abdominal pain, location of pain, and history of melena or vomiting.H. pylori was positively associated with hematemesis in the Limerick group. These findings demonstrate thatH. pylori infection in children is not associated with specific clinical symptomatology across varying geographical locations.P. Sherman is the recipient of a Career Scientist Award from the Ontario Ministry of Health.     

Helicobacter pylori infection in children

Helicobacter pylori was sought prospectively by culture of antral biopsy, histology and serology (IgG and IgA) in 440 consecutive endoscopies on children to determine the prevalence, clinical presentation and histological features of H. pylori infection in our population. Twenty-eight patients had H. pylori (8% overall). The mean age of infected patients was significantly higher than that of non-infected patients (P less than 0.0001). No patient under 5 years of age had H. pylori isolated. Overall, there was no significant difference in clinical presentation between those with and those without H. pylori infection, but 23% of patients 5 and 26 years of age who presented with abdominal pain as the indication for their endoscopy had H. pylori isolated. Macroscopic changes ranged from no abnormality to frank ulceration, but the typical antral mamilliform changes were 100% predictive of infection. Fifty-eight per cent of patients with duodenal ulcers, but only 17% with gastric ulcers had H. pylori infection. Histological gastritis was present in 144 patients (including all H. pylori positive patients). None of the patients with another definable cause for gastritis had H. pylori isolated. In conclusion, H. pylori is an important cause of primary gastritis in our population, occurring in children over 5 years of age. Culture of an antral biopsy should be performed in children over this age undergoing endoscopy for the investigation of abdominal pain and, more particularly, in those with peptic ulceration.     

Helicobacter pylori infection in patients with autoimmune thrombocytopenic purpura

AIM: To compare the prevalence of Helicobacter pylori(Hpylori) infection in autoimmune thrombocytopenic purpura (AITP) patients with that of nonthrombocytopenic controls,and to evaluate the efficacy of the treatment in Hpylori(+)and Hpylori(-) AITP patients.METHODS: The prevalence of gastric Hpyloriinfection in 38 adult AITP patients (29 female and 9 male; median age 27 years; range 18-39 years) who consecutively admitted to our clinic was investagated.RESULTS: Hpyloriinfection was found in 26 of 38 AITP patients (68.5%). Hpyloriinfection was found in 15 of 23 control subjects (65.2%). The difference in Hpyloriinfection between the 2 groups was not significant. Thrombocyte count of Hpylori-positive AITP patients was significantly lower than that of Hpylori-negative AITP patients (P＜0.05).Thrombocyte recovery of Hpylori-positive group was less than that of Hpylori-negative group (P＜0.05).CONCLUSION: Hpyloriinfection should be considerecd in the treatment of AITP patients with Hpyloriinfection.     

Helicobacter pylori infection in Icelandic children

Objective: The prevalence of Helicobacter pylori (HP) infection is decreasing in the western world. The seroprevalence among 25–50-year-old Icelandic adults was recently shown to be 30–40%. Information on the seroprevalence in Nordic children is limited. We aimed at ascertaining the infection prevalence among healthy Icelandic children.

Methods: The infection status in stored frozen blood samples from two cross-sectional studies on the health of 7–9-year-old children (n?=?125) and 16–18-year-old adolescents (n?=?80) was determined by enzyme-linked immunosorbent assay (ELISA). Information on family demographics and GI symptoms was obtained by standardized questionnaires.

Results: Overall, 3.4% (7/205) of the children were infected with H. pylori. The prevalence was 2.6% (5/190), missing data n?=?3, among children with both parents born in a low prevalence country compared to 17% (2/12) among those with at least one parent born in a high prevalence area (p?=?.026). When at least one parent was born in a high prevalence country, the odds ratio for being H. pylori seropositive was 2.2 (95% CI, 1.02–54.67), when adjusted for the educational status of the mother. There was no significant association between H. pylori infection and gastrointestinal symptoms.

Conclusion: Prevalence of H. pylori infection in Iceland has become very low, suggesting a great reduction in transmission from older generations. There was an association between H. pylori infection and origin from high prevalence areas but not with gastrointestinal symptoms. The results mirror recent studies of children of Scandinavian ancestry.     

Consequences of Helicobacter pylori infection in children

Although evidence is emerging that the prevalence of Helicobacter pylori (H. pylori) is declining in all age groups, the understanding of its disease spectrum continues to evolve. If untreated, H. pylori infection is lifelong. Although H. pylori typically colonizes the hu-man stomach for many decades without adverse con-sequences, children infected with H. pylori can manifest gastrointestinal diseases. Controversy persists regarding testing (and treating) for H. pylori infection in children with recurrent a...