幽门螺杆菌与慢性特发性荨麻疹的相关性探讨

慢性特发性荨麻疹是皮肤科常见的变态反应性疾病,是由皮肤、黏膜小血管反应性扩张和通透性增加而产生的一种局限性水肿反应.主要表现为风团.     

慢性荨麻疹患者幽门螺杆菌检测的意义

目的：研究慢性荨麻疹与幽门螺杆菌（Helicobacter pylori ,HP）感染的相关性,探讨HP检测在慢性荨麻疹患者诊疗中的意义。方法：选取2014年4月至2015年7月门诊治疗的慢性荨麻疹患者420例,并随机选取同期体检中心健康体检者450例为健康对照组,采用胶体金法检测患者及健康体检者血清HP尿素酶抗体,分析慢性荨麻疹组和健康对照组两组HP的阳性情况;同时将162例慢性荨麻疹HP阳性患者分为实验组88例和对照组74例,对照组患者应用常规荨麻疹治疗,实验组患者在对照组治疗基础上增加抗HP三联疗法,分析HP检测阳性的慢性荨麻疹患者采用不同治疗方法的临床疗效。结果：慢性荨麻疹组HP阳性率为38.6%,健康对照组HP阳性率为14.4%,差异有统计学意义（P<0.05）;HP检测阳性患者实验组临床疗效有效率显著高于对照组的有效率,差异有统计学意义（P<0.05）。结论：慢性荨麻疹与HP感染之间存在密切的相关性, HP检测对慢性荨麻疹患者的诊疗具有重要的临床意义。     

儿童慢性荨麻疹与幽门螺杆菌感染关系的初探

目的探讨儿童慢性荨麻疹与幽门螺杆菌感染的关系。方法随机选择来我院皮肤科诊治的慢性荨麻疹患儿62例,健康儿童32例,分为两组,分别进行13C-尿素呼气试验检测幽门螺杆菌,并对幽门螺杆菌阳性者给予抗幽门螺杆菌根治性治疗。对幽门螺杆菌阳性率及疗效进行统计学比较。结果慢性荨麻疹患儿组幽门螺杆菌阳性率高于健康对照组（P〈0.05）,而两组幽门螺杆菌转阴率并无统计学差异（P〉0.05）。结论幽门螺杆菌感染对儿童慢性荨麻疹的发生发展起到了一定的作用。     

三种抗原检测抗幽门螺杆菌抗体的临床意义评价

目的：寻求敏感性高、特异性强的ＨＰ抗原和简便、可靠的检测ＨＰ抗体的方法,用于诊断ＨＰ感染。方法：分别以ＨＰ尿素酶、全菌破碎物、培养上清液为抗原。采用斑点金标免疫渗滤法（ＤＩＧＦＡ）检测ＨＰ培养、病理组织学检查、尿素酶试验均阳性和均阴性的血清各５０份;胃镜检查各类胃病毒者血清２５８份,并以ＥＬＩＳＡ试剂盒做平行检测对照。结果：三种抗原的敏感性分别为１００％、９６％和７６％;５０份阴性血清的阴性符合率     

三联疗法治疗幽门螺杆菌相关慢性荨麻疹的疗效观察

荨麻疹是指皮肤、黏膜小血管反应性扩张和通透性增高而产生的一种局限性水肿反应, 主要表现在每天或几乎每天出现的皮肤风团及瘙痒, 分为急性荨麻疹和慢性荨麻疹(chronic urticaria, CU), 以CU发病率为高.CU病情大多反复发作, 并持续超过6周, 多数病因不易查出, 故迁延不愈, 给患者身体及心理造成了很大的负担.近来许多研究发现CU的发病与幽门螺杆菌(Helicobacter pylori, Hp)的感染关系密切, 现对近半年来我院就诊的58例CU患者的临床资料进行回顾性分析.     

幽门螺杆菌感染者血清NO检测的临床意义

198 2年Marshall和Warren从慢性活动性胃炎患者的胃粘膜中分离出幽门螺杆菌(HP)之后,HP与上消化道疾病之间的关系倍受关注。现已确认其是慢性胃炎的主要致病因子,且与消化性溃疡的发病密切相关,根除HP之后可以显著降低或防止溃疡复发[1 ] 。一氧化氮(NO)是由血管内皮细胞释放,起到调节血压、传递神经信息作用的一种物质。近年来研究表明,NO除参与调节血管、神经系统外,还对免疫系统起作用,是一种新的免疫分子炎性介质[2 ] 。本文对6 0例慢性胃病患者血清NO含量进行测定,以探讨血清NO水平变化与胃粘膜幽门螺杆菌感染关系。1　材料和方…     

幽门螺旋杆菌感染与小儿慢性荨麻疹

目的　探讨幽门螺旋杆菌与慢性荨麻疹之间的关系。方法　应用酶联免疫吸附 (ELISA)法对 2 4例慢性荨麻疹患儿及 30例健康体检儿童进行幽门螺旋杆菌 (Hp -IgG)检测 ,并对抗Hp -IgG抗体阳性的荨麻疹患儿进行了14 C尿素呼吸试验(14 C -UBT) ,2项均阳性患儿采用了根除Hp的治疗。结果　慢性荨麻疹组 2 4例中 11例Hp -IgG阳性 ,阳性率 4 5 .8% ,对照组4例抗Hp -IgG抗体阳性 ,两组比较差异有显著意义 (χ2 =7.0 2 ,P <0 .0 1)。 2 4例荨麻疹患儿Hp -IgG及14 C -UBT均阳性者10例 ,给予根除Hp的治疗后 4周随访 ,所有的患儿皮疹消退 ,复查14 C -UBT均为阴性。继续随访 1年 ,其中 8例未再复发 ,2例再次出现皮疹 ,经再次治疗后皮疹完全消失 ,未再复发。结论　幽门螺旋杆菌感染与慢性荨麻疹的发病有关。     

血清幽门螺杆菌抗体定量检测的临床价值

目的:分析体检人群幽门螺杆菌(HP)感染情况,并依据评价血清HP抗体定量检测的临床价值。方法:选取2019-10—2019-11于湖北省人民医院体检的405例体检者为研究对象,并根据尿素~(14)C呼气试验结果分为阳性组(n=223)和阴性组(n=182)。采用聚胶免疫比浊法法检测血清中HP抗体含量,以尿素~(14)C呼气试验结果为标准,评价血清HP抗体定量检测的敏感度、特异度、阳性预测值和阴性预测值。结果:体检人群中尿素~(14)C呼气试验的阳性率为55.6%,与阴性组相比,阳性组中血清HP抗体含量显著升高(P<0.01)。在尿素~(14)C呼气试验阳性的223例受试者中,其血清HP抗体定量检测阳性的例数为193,该检测敏感度为86.55%;在尿素~(14)C呼气试验阴性的182例受试者中,血清HP抗体定量检测阴性的例数为138,该检测的特异度为75.82%。血清HP抗体定量检测阳性预测值为81.43%,阴性预测值为82.14%。结论:血清抗体定量检测与尿素~(14)C呼气试验结果一致性较好,或可补充尿素~(14)C呼气试验的不足,更好地辅助临床诊断。     

慢性阻塞性肺病患者幽门螺杆菌感染状况与肺功能的关系

目的 探讨幽门螺杆菌(Helicobacter pylory,Hp)感染及其产生的毒力因子与慢性阻塞性肺病的关系.方法 根据GOLD指南临床确诊的80例COPD稳定期的患旨(男50例,女30例,平均年龄(58.11±10.5)岁),80例年龄和性别相当的正常健康志愿者作为对照组(男45例,女35例,半均年龄57.55±9.43).所有病例用幽门螺杆菌测定仪-AUTOBLOT SYSTEM36专用试剂盒通过免疫印迹法检测幽门螺杆菌血清抗体及进行肺功能检测.结果 ①COPD患者组幽门螺杆菌血清感染率为:71.25%,对照组幽门螺杆菌血清感染率为:43.75%(P=0.002).去除年龄、性别、吸烟及吸烟指数等危险因素后,Hp感染者患COPD的相对危险性明显增高,其OR值为3.19,95%CI为1.65-6.14.②COPD组中Ⅰ型Hp检出率高于对照组,分别为:38.75%和31.25%,去除年龄、性别、吸烟及吸烟指数等危险因素后Ⅰ型Hp菌株感染组患COPD的危险性显著增高,其OR值为3.68,95%CI为1.83-7.40,高于Hp感染阳性者患COPD危险性的OR值3.19.但Ⅱ型Hp菌株感染组并未明显增加患COPD的危险性,OR值为1.03,95%CI为0.41-2.57.结论 Hp感染是导致COPD的独立危险因素,Ⅰ型Hp感染可能更增加患COPD的危险性,且可能是使COPD患者肺功能恶化的因素之一.     

胃粘膜局部抗幽门螺杆菌抗体IgA的研究

采用胃粘膜体外培养技术和免疫印迹技术研究了５１例慢性胃炎和消化性溃疡患者胃粘膜局部抗幽门螺杆菌（Ｈｐ）抗体ＩｇＡ，同时对其中１０例Ｈｐ阳性患者的血清ＩｇＡ作了分析。结果表明：４０例Ｈｐ阳性患者除１例外，其粘膜抗ＨｐＩｇＡ抗体均为阳性；１１例Ｈｐ阴性患者中，２例胃粘膜局部ＩｇＡ阳性，９例为阴性。该方法与常规方法检测Ｈｐ的符合率为９２．２％。粘膜局部ＩｇＡ识别５条左右条带，且识别条带具多样性。１０例Ｈｐ阳性且局部ＩｇＡ阳性患者的血清ＩｇＡ亦为阳性，但血清ＩｇＡ的识别条带较局部ＩｇＡ少，且染色浅，说明抗ＨｇＩｇＡ抗体以局部为主，该局部ＩｇＡ的作用值得进一步研究。     

慢性湿疹及慢性荨麻疹患者血清胃泌素的变化及其临床意义

目的:研究慢性湿疹及慢性荨麻疹患者血清胃泌素的变化及其临床意义。方法:应用放射免疫分析测定63例慢性湿疹及37例慢性荨麻疹患者血清胃泌素水平, 43例年龄、性别相匹配的健康志愿者作为正常对照。结果:慢性湿疹组、慢性麻荨疹组与正常对照组血清胃泌素水平分别为(102 95±27 33)ng/L、(109 87±33 64)ng/L和(61 72±20 38)ng/L。经统计学分析,两疾病组与对照组之间均有显著性差异(P<0 01,P<0 01),而两疾病组之间无明显差异(P>0 05)。结论:慢性湿疹及慢性荨麻疹患者血清中胃泌素水平均增高,为临床治疗提供一定的指导意义。     

Natural History and Influencing Factors of Chronic Urticaria in Children

PurposeChronic urticaria (CU) can reduce the quality of life of children and their parents, but there are only a few studies on the course of CU in children. This study aimed to investigate the natural course of CU in children and identify the factors that influence its prognosis.MethodsWe evaluated 77 children diagnosed with CU, who were monitored for at least 48 months. Subjects were classified as either chronic spontaneous urticaria (CSU) or other CU, and the clinical features were compared. Remission was defined as having no symptoms without treatment for more than 1 year. The remission rate was analyzed, and the factors influencing the prognosis were investigated.ResultsThe average age of the study population was 5.96 ± 4.06 years, and 64 (83.1%) patients had CSU. The remission rates at 6 months, 1 year, 2 years, 3 years, and 4 years after symptom onset were 22.1%, 40.3%, 52.0%, 63.7%, and 70.2%, respectively, for children with CU. For children with CSU, these values were 23.4%, 43.7%, 56.2%, 68.7%, and 75.0%, respectively. The total serum immunoglobulin E (IgE) levels were positively correlated with disease duration (r = 0.262, P = 0.021); no other factors were associated with the duration of the disease.ConclusionsA high proportion of children with CU were classified as CSU. No indicators, except for total IgE were found to predict the timing of spontaneous remission. The CU remission rate identified in this study is expected to be used as one of the reference data for the progress of CU in patients.     

High prevalence of IgG and IgA antibodies to 19-kDa Helicobacter pylori-associated lipoprotein in chronic urticaria

BACKGROUND: Chronic urticaria has been described in patients with Helicobacter pylori infection. We studied the titer of IgG and IgA type antibodies against H. pylori in patients with and without urticaria of unknown etiology. We also investigated the prevalence of antibodies against H. pylori-associated lipoprotein 20 (lpp20) in patients with and without chronic urticaria. METHODS: The concentration of anti-H. pylori antibodies (IgG and IgA) was determined by the RIDA test. The level of anti-lpp20 antibodies was determined by Western blot using various H. pylori antigens (from 19 to 120 kDa). RESULTS: Patients with chronic urticaria and H. pylori infection (subgroup 1, n = 33) had high IgG and IgA titers whereas all patients with chronic urticaria and without H. pylori infection (subgroup 2, n = 23) were seronegative (P = 0.0128 for IgG and P = 0.003 for IgA). Titers in subgroup 1 did not differ significantly from a control group (n = 33) with severe H. pylori-associated gastritis without urticaria. The prevalence of the anti-lpp20 antibodies was significantly higher in subgroup 1 compared to the control group (93.9 vs 21.2%, P < 0.0001 for IgG, and 46.1 vs 6.3%, P < 0.0029 for IgA). CONCLUSIONS: We suggest that IgG and IgA antibodies to H. pylori-associated lpp20 may play role in the pathogenesis of chronic urticaria.     

Evaluation of Chronic Urticaria in Patients with Hashimoto Thyroiditis

The coincidence of Hashimoto thyroiditis (HT) and chronic idiopathic urticaria (CIU) is a commonly observed phenomenon in western New York. Previous literature suggested that there may be a direct relationship between them. We undertook these studies to determine whether humoral or cell-mediated mechanisms might link HT and CIU.Skin biopsies from patients with CIU, with or without HT, were indistinguishable by light microscopy. No immune complex deposition was observed, although only the skin from patients with CIU and HT contained perivascular fibrin deposits. Similarly, immunohistochemical studies evaluating cellular expression of CD3, CD4, CD8, CD20, and CD68 failed to differentiate between CIU with or without HT. Analysis of V restriction in thyroid tissue of patients with HT and the skin of patients with CIU and HT by in situ polymerase chain reaction failed to reveal any oligoclonal T-lymphocyte subpopulations. In contrast, only patients with CIU and HT had anti-FcRI antibodies in their sera that could induce degranulation of normal basophils. Some sera from patients with CIU and HT caused degranulation of normal basophils in the absence of anti-FceRI. The factor causing basophil degranulation in these sera was not determined. Patients with CIU and HT failed to improve clinically with thyroid replacement therapy. All CIU patients were equally well managed with symptomatic therapies.In conclusion, HT likely represents a marker of other autoimmunity, rather than being a direct causative agent in CIU. Management of CIU, with or without HT and with or without anti-FceRI antibodies, should be the same. Future studies will have to examine whether cell-mediated responses participate in CIU, especially in association with HT.     

IgY抗体在体外和体内对幽门螺杆菌作用的研究

目的 通过口服IgY抗体制剂中和幽门螺杆菌（Hp)的毒性蛋白，以达到根除Hp感染的目的。方法 将空泡毒素基因阳性Hp株培养后，用超滤浓缩的上清和超声破碎的菌体蛋白免疫产蛋母鸡，从鸡蛋中提取2种IgY抗体，用MTT法进行IgY抗体对Hp毒素细胞毒活性的中和作用试验，将此2种IgY抗体间隔2d分3次口服已感染Hp的小鼠，2、4、6、8周后分批处死小鼠，进行细菌培养、尿素酶试验和病理检查。结果 2种IgY抗体分别能够中和培养上清和菌体蛋白诱导的Vero细胞毒活性。感染小鼠经治疗后细菌培养阴转率分别达66．7％、100％、100％、100％。病理切片显示，炎症明显减轻甚至消失。结论 口服IgY抗体制剂可能是治疗Hp感染的一种有效方法。     

四联疗法治疗幽门螺旋杆菌相关性十二指肠球炎疗效分析

目的 比较标准四联与三联法治疗幽门螺旋杆菌相关性十二指肠球炎临床疗效。方法 选择2017年5月~2018年5月我院收治的幽门螺旋杆菌相关性十二指肠球炎患者96例,随机分为观察组和对照组,每组48例。观察组采用兰索拉唑、克拉霉素、阿莫西林、果胶铋标准四联治疗,对照组采用兰索拉唑、克拉霉素、阿莫西林标准三联治疗。比较两组患者Hp根除率、复发率及不良反应情况。结果 观察组患者Hp根除率为91.67%,高于对照组75.00%,差异具有统计学意义（P＜0.05）。观察组患者Hp复发率为10.42%,低于对照组的20.83%,差异具有统计学意义（P＜0.05）。观察组不良反应发生率为4.16%,低于对照组的6.25%,但组间比较,差异无统计学意义（P＞0.05）。结论 标准四联疗法治疗幽门螺旋杆菌相关性十二指肠球炎,Hp根除率较高,复发率低,且不增加不良反应发生率。     

幽门螺杆菌粪便抗原检测方法学评价

目的 评价幽门螺杆菌粪便抗原（ HpSA）检测在诊断患者幽门螺杆菌（Hp）感染中的价值.方法 以胃镜病理学诊断结果为金标准,对328例有消化道症状患者粪便,同时应用酶联免疫吸附实验检测幽门螺杆菌粪便抗原,计算HpSA检测诊断Hp感染的特异性、灵敏度和准确性等性能指标.结果 幽门杆菌粪便抗原酶免疫检测法对Hp感染诊断与金标准相比无统计学差异（P＞0.05）,其敏感性为94.6％、特异性为96.9％、准确性为96.3％、阳性预期值为89.7％、阴性预期值为98.4％.结论 幽门螺杆菌粪便抗原酶免疫检测是一种简便、易行、准确性高、便宜、易重复的非侵入性检测方法.     

根除儿童口腔幽门螺杆菌预防胃内幽门螺杆菌感染的多中心研究

目的:探讨根除儿童口腔幽门螺杆菌（Hp）预防胃内Hp感染的可能性。方法:采用多中心前瞻随机研究,选取口腔Hp阳性但胃内Hp阴性的幼儿园儿童共计427例,随机分为使用“无幽梅”牙膏组与普通牙膏组,分别接受“无幽梅”牙膏和普通牙膏。疗程结束后,再次检测口腔Hp,将口腔Hp阳性及阴性患者各分为一组,1年后行C13呼气试验检查,分析两组患者胃内Hp感染情况。口腔Hp检测方法采用特异度及敏感度双高的套式PCR方法。结果:随访1年,口腔Hp阴性组胃内Hp感染率为0.51%,口腔Hp阳性组胃内Hp感染率为6.51%,两组统计差异具有显著性（P<0.01）。结论:儿童根除口腔Hp可以降低胃内Hp感染的发生。