【摘要】：[目的]檢測(cè)HSP患兒糞便中sIgA含量和血漿中二胺氧化酶、D-乳酸及內(nèi)毒素含量,探討HSP患兒腸道免疫功能及腸屏障功能的變化,以便提升對(duì)HSP的發(fā)病機(jī)制認(rèn)識(shí),為HSP的治療提供理論依據(jù)。[方法]選取2014-2016年在昆明醫(yī)科大學(xué)第一附屬醫(yī)院確診為HSP的住院患兒為研究組,另選取2015年某小學(xué)健康兒童志愿者為對(duì)照組。采集HSP患兒急性期、恢復(fù)期及健康兒童糞便及血液標(biāo)本,采用ELISA方法檢測(cè)各組兒童糞便中sIgA含量、血漿中D-乳酸及血漿中內(nèi)毒素含量,采用分光光度法檢測(cè)各組兒童血漿中二胺氧化酶活性,所有研究數(shù)據(jù)經(jīng)統(tǒng)計(jì)學(xué)方法處理。[結(jié)果]HSP患兒急性期和恢復(fù)期糞便中sIgA含量高于健康兒童,差異有統(tǒng)計(jì)學(xué)意義(P0. 017),急性期與恢復(fù)期糞便中sIgA含量比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0. 017);腹型HSP患兒急性期和恢復(fù)期組糞便中sIgA含量高于健康兒童,差異有統(tǒng)計(jì)學(xué)意義(P(). 017),非腹型急性期和恢復(fù)期組與健康對(duì)照組糞便中sIgA含量比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0. 017),腹型與非腹型急性期和恢復(fù)期組糞便中sIgA含量比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0. 017)。HSP患兒急性期和恢復(fù)期血漿中二胺氧化酶活性高于健康兒童,差異有統(tǒng)計(jì)學(xué)意義(P0. 05),急性期與恢復(fù)期血漿中二胺氧化酶活性比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0. 05);腹型與非腹型HSP患兒急性期和恢復(fù)期組血漿中二胺氧化酶活性高于健康兒童,差異有統(tǒng)計(jì)學(xué)意義(P0. 05),腹型與非腹型急性期、恢復(fù)期組血漿中二胺氧化酶活性比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0. 05)。HSP患兒急性期血漿中D-乳酸含量高于健康兒童,差異有統(tǒng)計(jì)學(xué)意義(P0.017),恢復(fù)期與健康對(duì)照組血漿中D-乳酸含量比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0. 017),急性期與恢復(fù)期血漿中D-乳酸含量比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0. 017);腹型HSP患兒急性期組血漿中D-乳酸含量高于健康兒童,差異有統(tǒng)計(jì)學(xué)意義(P0.017),非腹型急性期組與健康對(duì)照組血漿中D-乳酸含量比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.017),腹型與非腹型急性期組血漿中D-乳酸含量比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0. 017); HSP患兒恢復(fù)期腹型組、恢復(fù)期非腹型組、健康對(duì)照組血漿中D-乳酸含量比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。HSP患兒急性期和恢復(fù)期血漿中內(nèi)毒素含量高于健康兒童,差異有統(tǒng)計(jì)學(xué)意義(P0. 017),急性期與恢復(fù)期血漿中內(nèi)毒素含量比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.017);腹型HSP患兒急性期、恢復(fù)期組血漿中內(nèi)毒素含量高于健康兒童,差異有統(tǒng)計(jì)學(xué)意義(P0.017),非腹型急性期、恢復(fù)期組與健康對(duì)照組血漿中內(nèi)毒素含量比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0. 017),腹型與非腹型急性期、恢復(fù)期組血漿中內(nèi)毒素含量比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0. 017)。[結(jié)論]HSP患兒血漿中二胺氧化酶、D-乳酸及內(nèi)毒素含量升高,提示腸道通透性增加和腸屏障功能有改變;HSP患兒糞便中sIgA含量升高,可能由于腸屏障功能障礙,導(dǎo)致sIgA反應(yīng)性增高;恢復(fù)期HSP患兒腸屏障功能尚未完全恢復(fù)至正常;腹型及非腹型HSP患兒均存在腸屏障功能障礙,但腹型腸屏障功能損傷較非腹型嚴(yán)重。
文內(nèi)圖片：
圖片說(shuō)明：圖１不問(wèn)類(lèi)型ＨＳＰ患兒及健康兒童糞便中ｓｌｇＡ含景比較逡逑
[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.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R725.5

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