[1]潘 馨,刘佳奕,王 艳,等.幽门螺杆菌感染与儿童过敏性紫癜相关性的Meta分析[J].医学信息,2023,36(02):92-98.[doi:10.3969/j.issn.1006-1959.2023.02.018]
　PAN Xin,LIU Jia-yi,WANG Yan,et al.Meta-analysis of the Correlation Between Helicobacter Pylori Infection and Henoch-Sch?nlein Purpura in Children[J].Journal of Medical Information,2023,36(02):92-98.[doi:10.3969/j.issn.1006-1959.2023.02.018]
点击复制

幽门螺杆菌感染与儿童过敏性紫癜相关性的Meta分析()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年02期
页码:
92-98
栏目:
论著
出版日期:
2023-01-15

文章信息/Info

Title:
Meta-analysis of the Correlation Between Helicobacter Pylori Infection and Henoch-Sch?nlein Purpura in Children
文章编号:
1006-1959（2023）02-092-07
作者:
潘 馨; 刘佳奕; 王 艳; 等
（1.成都中医药大学临床医学院，四川 成都 610075；2.成都中医药大学附属医院儿科，四川 成都 610075）
Author(s):
PAN Xin; LIU Jia-yi; WANG Yan; et al.
(1.College of Clinical Medicine,Chengdu University of Traditional Chinese Medicine,Chengdu 610075,Sichuan,China; 2.Department of pediatrics,Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610075,Sichuan,China)
关键词:
幽门螺杆菌; 过敏性紫癜; 病例对照研究
Keywords:
Helicobacter pylori; Henoch-Sch?觟nlein purpura; Case-control study
分类号:
R554+.6
DOI:
10.3969/j.issn.1006-1959.2023.02.018
文献标志码:
A
摘要:
目的 探究儿童幽门螺旋杆菌（Hp）感染和过敏性紫癜（HSP）的发病是否具有相关性，为探讨HSP的病因病理提供依据。方法 系统检索CNKI、WanFang Data、MEDLINE、Cochrane Library、EMbase、Web of Science、VIP等数据库中有关Hp感染与儿童HSP相关性的研究文献，检索时限为建库起至2022年12月。使用Endnote整理筛选文献，文献质量评价采用纽卡斯尔渥太华量表。研究基本特征、效应量以及计算效应量所需相关数据由2名独立研究人员进行提取。采用RevMan5.3软件和STATA16.0软件进行Meta分析，使用随机效应模型对数据进行计算。结果 共纳入15项病例对照研究，包括2676例研究对象，纳入研究NOS评分为6~7分。Meta分析显示，儿童HSP组Hp感染阳性率高于健康儿童对照组，差异有统计学意义（OR=4.32，95%CI：3.07~6.10，P＜0.000 01）。考虑到不同检测指标、地域对研究的异质性产生影响，进行亚组分析及Meta回归分析，提示这2个因素未被确定为异质性的潜在危险因素。腹型和肾型HSP合并结果均提示腹型和肾型紫癜发病可能与Hp感染有关，但不能明确其相关性是否比其它类型紫癜更强，HSP儿童中腹型紫癜（OR=5.35，95%CI：2.59~11.05，P=0.000），肾型紫癜（OR=5.30，95%CI：1.05~26.61，P=0.043）可能与Hp感染有关。结论 儿童Hp感染和HSP发病存在一定相关性，其与HSP分型的相关性尚不明确，儿童Hp感染可能是HSP的发病原因之一，甚至可能是病理机制中的重要环节，但以上结论有待更多多中心、大样本、高质量的研究以得出更可靠的结论。
Abstract:
Objective To explore the correlation between Helicobacter pylori (Hp) infection and the incidence of Henoch-Sch?nlein purpura (HSP) in children, and to provide evidence for the etiology and pathology of HSP.Methods CNKI, WanFang Data, MEDLINE, Cochrane Library, Embase, Web of Science, VIP and other databases were systematically searched for research literature on the correlation between Hp infection and HSP in children from inception to December 2022. Endnote was used to screen the literature, and the Newcastle Ottawa Scale was used to evaluate the quality of the literature. The basic characteristics of the study, the effect size and the relevant data required to calculate the effect size were extracted by two independent researchers. Meta-analysis was performed using RevMan5.3 software and STATA16.0 software, and the data were calculated using a random effect model.Results A total of 15 case-control studies were included, including 2676 subjects, and the NOS score was 6-7. Meta-analysis showed that the positive rate of Hp infection in children with HSP was higher than that in healthy children (OR=4.32,95%CI:3.07-6.10,P<0.000 01). Considering the influence of different detection indicators and regions on the heterogeneity of the study, subgroup analysis and Meta regression analysis were carried out, suggesting that these two factors were not identified as potential risk factors for heterogeneity. The combined results of abdominal and renal HSP suggested that the incidence of abdominal and renal purpura might be related to Hp infection, but it was not clear whether the correlation was stronger than other types of purpura. Among children with HSP, abdominal purpura (OR=5.35,95%CI:2.59-11.05,P=0.000) and renal purpura (OR=5.30,95%CI:1.05-26.61,P=0.043) may be related to Hp infection.Conclusion There is a certain correlation between Hp infection and HSP in children, but the correlation between Hp infection and HSP classification is not clear. Hp infection in children may be one of the causes of HSP, and may even be an important part of the pathological mechanism. However, the above conclusions need more multi-center, large-sample and high-quality studies to draw more reliable conclusions.

参考文献/References:

[1]Davin JC,Coppo R.Henoch-Sch?觟nlein purpura nephritis in children[J].Nat Rev Nephro,2014,10(10):563-573.[2]周杏,刘志刚.儿童腹型过敏性紫癜32例临床资料的回顾性分析[J].现代消化及介入诊疗,2014(2):112-114.[3]Xiong LJ,Mao M.Current views of the relationship between Helicobacter pylori and Henoch-Schonlein purpura in children[J].World J Clin Pediatr,2016,5(1):82-88.[4]Shin JI,Lee KH,Joo YH,et al.Inflammasomes and autoimmune and rheumatic diseases: A comprehensive review[J].J Autoimmun,2019,103:102299.[5]Xiong LJ,Tong Y,Wang ZL,et al.Is Helicobacter pylori infection associated with Henoch-Schonlein purpura in Chinese children? a meta-analysis[J].World J Pediatr,2012,8(4):301-308.[6]Shin JI,Koh H,Lee JS.Henoch-Sch?觟nlein purpura associated with helicobacter pylori infection: the pathogenic roles of IgA, C3, and cryoglobulins?[J].Pediatr Dermatol,2009,26(6):768-769.[7]朱由瑾,温丽英,杨晓静,等.儿童过敏性紫癜发病与微生物感染的相关性研究[J].临床皮肤科杂志,2020,49(9):529-532.[8]Stang A.Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses[J].Eur J Epidemiol,2010,25(9):603-605.[9]曾静好,覃超强,赖永艺,等.幽门螺杆菌感染与儿童过敏性紫癜相关性研究[J].中国医药科学,2018,8(2):49-51,54.[10]关静,马国瑞,张雪玲.幽门螺杆菌感染对过敏性紫癜患儿的影响[J].中国微生态学杂志,2021,33(3):304-308.[11]季雪红,赵冬梅.幽门螺杆菌与儿童过敏性紫癜性肾炎相关性探讨[J].新疆医学,2015,45(6):716-718,736.[12]莱杜万,季红,刘玲,等.幽门螺杆菌与儿童过敏性紫癜的关系[J].吉林医学,2013,34(12):2014-2015.[13]李晶,刘华林,叶倩.幽门螺杆菌感染与儿童过敏性紫癜相关性研究[J].医学理论与实践,2008,21(3):266-267.[14]李宇红,朱莉,邵晓珊,等.幽门螺杆菌感染与过敏性紫癜的相关性探讨[J].遵义医学院学报,2008,31(4):398-400.[15]王国峰,李贵华,尚云,等.C反应蛋白和幽门螺杆菌感染与小儿腹型过敏性紫癜关系的临床研究[J].四川生理科学杂志,2021,43(6):978-980.[16]王军红.幽门螺杆菌感染和C反应蛋白与小儿腹型过敏性紫癜关系的临床研究[D].济南:山东大学,2020.[17]王硕,张小飞,荣爱红,等.幽门螺杆菌分型与儿童腹型过敏性紫癜的关系[J].中国实验诊断学,2018,22(4):680-681.[18]王志超,刘金祥.不同类型幽门螺杆菌感染与儿童过敏性紫癜发病风险、临床表型的关联性研究[J].实用临床医药杂志,2020,24(6):57-60.[19]许崇艳,赵文,潘纪红.抗HP三联治疗与复发难治性过敏性紫癜关系的临床分析[J].中华实用中西医杂志,2007,20(23):2028-2029.[20]袁俊梅,陈海燕.复发型过敏性紫癜与幽门螺杆菌感染关系探讨[J].医药论坛杂志,2007,28(3):67-68. [21]张保霞.儿童幽门螺杆菌感染与过敏性紫癜相关性研究[J].医药论坛杂志,2017,38(1):120-121.[22]赵波,廖亚彬,蒋雪梅.昆明地区儿童过敏性紫癜感染相关因素分析[J].昆明医科大学学报,2013,34(6):113-115.[23]朱晓琴,王萍.西宁地区幽门螺旋杆菌感染与小儿腹型过敏性紫癜的关系探讨[J].现代预防医学,2011,38(13):2484,2486.[24]董毅.血清HP-IgG抗体分析对不同年龄HP感染者的诊断价值以及与根除治疗的关系[D].长春:吉林大学,2016.[25]Best LM,Takwoingi Y,Siddique S,et al.Non-invasive diagnostic tests for Helicobacter pylori infection[J].Cochrane Database Syst Rev,2018,3(3):CD012080.[26]石乐琴,郑荣梁,王秉瑞.幽门螺杆菌[J].微生物学免疫学进展,2007,35(3):51-68.[27]Suerbaum S,Michetti P.Helicobacter pylori infection[J].N Engl J Med,2002,347(15):1175-1186.[28]Barratt J,Bailey EM,Buck KS,et al.Exaggerated systemic antibody response to mucosal Helicobacter pylori infection in IgA nephropathy[J].Am J Kidney Dis,1999,33(6):1049-1057. [29]刘继荣,姜婷,向赛,等.儿童过敏性紫癜发病的危险因素研究[J].基因组学与应用生物学,2019,38(3):1329-1334.[30]Xia J,Wang M,Jiang W.New insights into pathogenesis of IgA nephropathy[J].Int Urol Nephrol,2022,54(8):1873-1880.[31]Lau KK,Suzuki H,Novak J,et al.Pathogenesis of Henoch-Sch?觟nlein purpura nephritis[J].Pediatr Nephrol,2010,25(1):19-26.[32]Song Y,Huang X,Yu G,et al.Pathogenesis of IgA Vasculitis: An Up-To-Date Review[J].Front Immunol,2021,12:771619.[33]Tang M,Zhang X,Li X,et al.Serum levels of galactose-deficient IgA1 in Chinese children with IgA nephropathy, IgA vasculitis with nephritis, and IgA vasculitis[J].Clin Exp Nephrol,2021,25(1):37-43.[34]Xiang Z,Censini S,Bayeli PF,et al.Analysis of expression of CagA and VacA virulence factors in 43 strains of Helicobacter pylori reveals that clinical isolates can be divided into two major types and that CagA is not necessary for expression of the vacuolating cytotoxin[J].Infect Immun,1995,63(1):94-98.[35]Takata T,Fujimoto S,Anzai K,et al.Analysis of the expression of CagA and VacA and the vacuolating activity in 167 isolates from patients with either peptic ulcers or non-ulcer dyspepsia[J].Am J Gastroenterol,1998,93(1):30-34.[36]戴好.半乳糖缺陷IgA1（Gd-IgA1）在IgA肾病发病机制中的作用[D].北京:北京协和医学院,2019.[37]Heineke MH,Ballering AV,Jamin A,et al.New insights in the pathogenesis of immunoglobulin A vasculitis (Henoch-Sch?觟nlein purpura)[J].Autoimmun Rev,2017,16(12):1246-1253.[38]董玉红,史应进,刘开运,等.蒙汉族儿童过敏性紫癜临床特点对比分析[J].中国基层医药,2003,10(11):1155-1156.[39]任少敏,郭妍妍,高忠献,等.蒙古族小儿过敏性紫癜88例临床特点分析[J].中国医师杂志,2002,4(3):269-271.[40]仝林虎,任少敏,郝富,等.蒙汉族儿童过敏性紫癜多器官损害与HLA-DRB1基因的关联性[J].中华微生物学和免疫学杂志,2003,23(2):136.

相似文献/References:

[1]郭绍敏.克拉霉素四联方案对一线方案根除失败的幽门螺杆菌的再根除效果评估[J].医学信息,2018,31(02):121.[doi:10.3969/j.issn.1006-1959.2018.02.044]
　GUO Shao-min.Evaluation of the Re-eradication Effect of Clarithromycin Quadruple Regimen on Helicobacter Pylori Eradication Failure in the First Line Scheme[J].Journal of Medical Information,2018,31(02):121.[doi:10.3969/j.issn.1006-1959.2018.02.044]
[2]罗宜辉,刘代华.益生菌联合四联方案根除幽门螺杆菌的临床研究[J].医学信息,2018,31(11):25.[doi:10.3969/j.issn.1006-1959.2018.11.008]
　LUO Yi-hui,LIU Dai-hua.Clinical Study on the Eradication of Helicobacter Pylori by Probiotics Combined with Quadruple Regimen[J].Journal of Medical Information,2018,31(02):25.[doi:10.3969/j.issn.1006-1959.2018.11.008]
[3]谢桃李,孙礼宾.血清25-羟维生素D在过敏性紫癜中的研究[J].医学信息,2019,32(09):116.[doi:10.3969/j.issn.1006-1959.2019.09.038]
　XIE Tao-li,SUN Li-bin.Study on Serum 25-hydroxyvitamin D in Henoch-Sch?觟nlein Purpura[J].Journal of Medical Information,2019,32(02):116.[doi:10.3969/j.issn.1006-1959.2019.09.038]
[4]关 楠.平凉市儿童过敏性紫癜相关环境因素调查研究[J].医学信息,2019,32(11):144.[doi:10.3969/j.issn.1006-1959.2019.11.042]
　GUAN Nan.Investigation on Environmental Factors Related to Children's Henoch-Schonlein Purpura in Pingliang City[J].Journal of Medical Information,2019,32(02):144.[doi:10.3969/j.issn.1006-1959.2019.11.042]
[5]冯晓阳,陆海涛,王 薇,等.溶菌酶肠溶片治疗过敏性紫癜的临床疗效[J].医学信息,2019,32(19):153.[doi:10.3969/j.issn.1006-1959.2019.19.050]
　FENG Xiao-yang,LU Hai-tao,WANG Wei,et al.Clinical Efficacy of Lysozyme Enteric-coated Tablets in the Treatment of Henoch-Schonlein Purpura[J].Journal of Medical Information,2019,32(02):153.[doi:10.3969/j.issn.1006-1959.2019.19.050]
[6]张 健.孟鲁司特钠联合氯雷他定治疗小儿过敏性紫癜的疗效及对炎性因子、免疫球蛋白水平的影响[J].医学信息,2022,35(15):107.[doi:10.3969/j.issn.1006-1959.2022.15.024]
　ZHANG Jian.Effect of Montelukast Sodium Combined with Loratadine in the Treatment of Anaphylactoid Purpura in Children and its Effect on Inflammatory Factors and Immunoglobulin Levels[J].Journal of Medical Information,2022,35(02):107.[doi:10.3969/j.issn.1006-1959.2022.15.024]
[7]马艳会,寇 毅.幽门螺杆菌感染与结直肠腺瘤临床特征的相关性研究[J].医学信息,2022,35(16):102.[doi:10.3969/j.issn.1006-1959.2022.16.024]
　MA Yan-hui,KOU Yi.Correlation Between Helicobacter Pylori Infection and Clinical Features of Colorectal Adenoma[J].Journal of Medical Information,2022,35(02):102.[doi:10.3969/j.issn.1006-1959.2022.16.024]
[8]华启洋,吴同利,刘永艳,等.幽门螺杆菌在胃食管反流病发病中的作用[J].医学信息,2019,32(20):103.[doi:10.3969/j.issn.1006-1959.2019.20.029]
　HUA Qi-yang,WU Tong-li,LIU Yong-yan,et al.The Role of Helicobacter Pylori in the Pathogenesis of Gastroesophageal Reflux Disease[J].Journal of Medical Information,2019,32(02):103.[doi:10.3969/j.issn.1006-1959.2019.20.029]
[9]陶源,徐俊林,张艳,等.上消化道黏膜病变病理诊断结果分析[J].医学信息,2020,33(02):125.[doi:10.3969/j.issn.1006-1959.2020.02.036]
　TAO Yuan,XU Jun-lin,ZHANG Yan,et al.Analysis of Pathological Diagnosis for Upper Gastrointestinal Mucosal Lesions[J].Journal of Medical Information,2020,33(02):125.[doi:10.3969/j.issn.1006-1959.2020.02.036]
[10]周 政.胃息肉与幽门螺杆菌感染的关系[J].医学信息,2021,34(21):91.[doi:10.3969/j.issn.1006-1959.2021.21.023]
　ZHOU Zheng.Relationship Between Gastric Polyps and Helicobacter Pylori Infection[J].Journal of Medical Information,2021,34(02):91.[doi:10.3969/j.issn.1006-1959.2021.21.023]

更新日期/Last Update: 1900-01-01