不同类型过敏性紫癜患儿粪sIgA与肠屏障功能变化及其意义

发布时间：2019-07-05 18:36

【摘要】：[目的]检测HSP患儿粪便中sIgA含量和血浆中二胺氧化酶、D-乳酸及内毒素含量,探讨HSP患儿肠道免疫功能及肠屏障功能的变化,以便提升对HSP的发病机制认识,为HSP的治疗提供理论依据。[方法]选取2014-2016年在昆明医科大学第一附属医院确诊为HSP的住院患儿为研究组,另选取2015年某小学健康儿童志愿者为对照组。采集HSP患儿急性期、恢复期及健康儿童粪便及血液标本,采用ELISA方法检测各组儿童粪便中sIgA含量、血浆中D-乳酸及血浆中内毒素含量,采用分光光度法检测各组儿童血浆中二胺氧化酶活性,所有研究数据经统计学方法处理。[结果]HSP患儿急性期和恢复期粪便中sIgA含量高于健康儿童,差异有统计学意义(P0. 017),急性期与恢复期粪便中sIgA含量比较差异无统计学意义(P0. 017);腹型HSP患儿急性期和恢复期组粪便中sIgA含量高于健康儿童,差异有统计学意义(P(). 017),非腹型急性期和恢复期组与健康对照组粪便中sIgA含量比较差异无统计学意义(P0. 017),腹型与非腹型急性期和恢复期组粪便中sIgA含量比较差异无统计学意义(P0. 017)。HSP患儿急性期和恢复期血浆中二胺氧化酶活性高于健康儿童,差异有统计学意义(P0. 05),急性期与恢复期血浆中二胺氧化酶活性比较差异无统计学意义(P0. 05);腹型与非腹型HSP患儿急性期和恢复期组血浆中二胺氧化酶活性高于健康儿童,差异有统计学意义(P0. 05),腹型与非腹型急性期、恢复期组血浆中二胺氧化酶活性比较差异无统计学意义(P0. 05)。HSP患儿急性期血浆中D-乳酸含量高于健康儿童,差异有统计学意义(P0.017),恢复期与健康对照组血浆中D-乳酸含量比较差异无统计学意义(P0. 017),急性期与恢复期血浆中D-乳酸含量比较差异无统计学意义(P0. 017);腹型HSP患儿急性期组血浆中D-乳酸含量高于健康儿童,差异有统计学意义(P0.017),非腹型急性期组与健康对照组血浆中D-乳酸含量比较差异无统计学意义(P0.017),腹型与非腹型急性期组血浆中D-乳酸含量比较差异无统计学意义(P0. 017); HSP患儿恢复期腹型组、恢复期非腹型组、健康对照组血浆中D-乳酸含量比较差异无统计学意义(P0.05)。HSP患儿急性期和恢复期血浆中内毒素含量高于健康儿童,差异有统计学意义(P0. 017),急性期与恢复期血浆中内毒素含量比较差异无统计学意义(P0.017);腹型HSP患儿急性期、恢复期组血浆中内毒素含量高于健康儿童,差异有统计学意义(P0.017),非腹型急性期、恢复期组与健康对照组血浆中内毒素含量比较差异无统计学意义(P0. 017),腹型与非腹型急性期、恢复期组血浆中内毒素含量比较差异无统计学意义(P0. 017)。[结论]HSP患儿血浆中二胺氧化酶、D-乳酸及内毒素含量升高,提示肠道通透性增加和肠屏障功能有改变;HSP患儿粪便中sIgA含量升高,可能由于肠屏障功能障碍,导致sIgA反应性增高;恢复期HSP患儿肠屏障功能尚未完全恢复至正常;腹型及非腹型HSP患儿均存在肠屏障功能障碍,但腹型肠屏障功能损伤较非腹型严重。
文内图片：

图片说明：图１不问类型ＨＳＰ患儿及健康儿童粪便中ｓｌｇＡ含景比较逡逑
[Abstract]:[Objective] To study the content of sIgA and the content of diamine oxidase, D-lactic acid and endotoxin in the stool of children with HSP, and to study the changes of intestinal immune function and intestinal barrier function in children with HSP, so as to raise the understanding of the pathogenesis of HSP and provide a theoretical basis for the treatment of HSP. [Methods] A group of hospitalized children diagnosed with HSP in the First Affiliated Hospital of Kunming Medical University in 2014-2016 was selected as the study group, and a group of healthy children in primary school in 2015 was selected as the control group. The contents of sIgA, D-lactic acid and endotoxin in the feces of each group were detected by ELISA, and the activity of diamine oxidase in the plasma of each group was detected by spectrophotometry. All study data was statistically processed. [Results] The content of sIgA in the stool of HSP in the acute and recovery period was higher than that of healthy children (P0. There was no significant difference in the content of sIgA in the feces of the acute and recovery period (P0. No.017). The sIgA content in the stool of the acute and recovery group was higher than that of healthy children (P (). No significant difference was found between the contents of sIgA in the feces of the non-abdominal type and the recovery group and the healthy control group (P0. There was no significant difference in the content of sIgA in the stool of the acute and recovery group of the non-abdominal type and the non-abdominal type (P0. 017). The activity of diamine oxidase in plasma of HSP in acute and recovery period was higher than that of healthy children. 05) There was no significant difference in the activity of diamine oxidase in the plasma of acute and recovery period (P0. 05), the activity of diamine oxidase in the plasma of the acute and recovery group of the abdominal and non-abdominal HSP children was higher than that of healthy children (P0. There was no significant difference in the activity of diamine oxidase in the plasma of the acute and recovery group (P0.05). 05). The content of D-lactic acid in plasma of the patients with HSP was higher than that of healthy children (P <0.017). The difference of D-lactic acid in the plasma of the healthy control group was not statistically significant (P0. No significant difference was found between the levels of D-lactic acid in the plasma of the acute and recovery period (P0. The content of D-lactic acid in plasma of acute phase group was higher than that of healthy children (P0.01). The difference of D-lactic acid in plasma of non-abdominal-type HSP and healthy control group was not statistically significant (P0.01). There was no significant difference in the content of D-lactic acid in the plasma of the acute and non-abdominal acute group (P0. There was no significant difference in the content of D-lactic acid in the plasma of the healthy control group (P0.05). The content of endotoxin in the plasma of HSP in the acute and recovery period was higher than that of healthy children (P 0.05). There was no significant difference in the content of endotoxin in the plasma of acute and recovery period (P0.01), and the content of endotoxin in the plasma of the acute and recovery group was higher than that of healthy children (P0.01). There was no significant difference in the content of endotoxin in the plasma of the recovery group and the healthy control group (P0. There was no significant difference in the content of endotoxin in the plasma of the acute and recovery group (P0.05). 017). [Conclusion] The increase of the content of diamine oxidase, D-lactic acid and endotoxin in the plasma of children with HSP showed that the increase of intestinal permeability and the function of the intestinal barrier were changed; the content of sIgA in the feces of the HSP children increased, which could result in the increase of sIgA reactivity due to the dysfunction of the intestinal barrier. In the recovery period, the intestinal barrier function of the children with HSP had not fully recovered to normal; there were intestinal barrier dysfunction in both the abdominal and non-abdominal HSP children, but the function of the abdominal intestinal barrier was more severe than that of the non-abdominal type.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R725.5

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