Abstract: ob＜x＞jective To analyze the correlation between changes of the ratio of bifidobacterium to Escherichia coli (B/E value) and serum galactose-deficient IgA1 (Gd-IGA1), transforming growth factor-β1 (TGF-β1) and insulin-like growth factor-1 (IGF-1) in children with Henoch-Schonlein purpura (HSP). Methods A total of 128 children with HSP who were hospitalized in the department of pediatrics of our hospital from January 2018 to May 2020 were selected as the study subjects. They were divided into normal HSP group with 73 cases and Henoch-Schonlein purpura nephritis (HSPN) group with 55 cases according to whether they had accumulated to the kidney. Another 50 healthy children in the same period were selected as the control group. The number of bifidobacterium and Escherichia coli in feces was detected by 16S rDNA fluorescence quantitative PCR, and the B/E value was calculated. Enzyme-li＜x＞nked immunosorbent assay was used to detect levels of serum galactose-deficient IgA1 (Gd-IGA1), transforming growth factor-β1 (TGF-β1) and insulin-like growth factor-1 (IGF-1). The correlation between B/E value and serum Gd-IGA1, TGF-β1 and IGF-1 was explored. Results The total values of intestinal bifidobacterium and B/E in HSP group were lower than those in the control group (6.45±0.84)LogN/g wet stools vs (7.47±0.52)LogN/g wet stools, (0.96±0.20) vs (1.27±0.64), and the number of Escherichia coli and levels of serum Gd-IgA1, TGF-β1 and IGF-1 were higher than those in the control group (6.72±0.70)LogN/g wet stools vs (5.90±0.38)LogN/g wet stools, (2526.27±270.86)U/mL vs (2198.45±240.42)U/mL, (6.47±1.85)ng/L vs (4.28±1.40)ng/L, (156.94±22.20)ng/L vs (128.20±18.64)ng/L (P < 0.05); The values of intestinal bifidobacterium and B/E in HSPN group were lower than those in normal HSP group(6.63±0.82)LogN/g wet stools vs (6.14±0.40)LogN/g wet stools, (1.03±0.12) vs (0.90±0.10), and the number of Escherichia coli and the levels of serum Gd-IGA1, TGF-β1 and IGF-1 were higher than those in the control group (6.45±0.62)LogN/g wet stools vs (6.84±0.33)LogN/g wet stools, (2445.80±220.40)U/mL vs (2620.58±188.17)U/mL, (5.96±0.88)ng/L vs (6.78±0.82)ng/L, (143.75±20.15)ng/L vs (170.07±18.48) ng/L (P < 0.05); Pearson correlation analysis showed that intestinal flora B/E value was significantly negatively correlated with serum Gd-IgA1, TGF-β1 and IGF-1 (r=-0.686, -0.652, -0.598, P < 0.05). Conclusion The intestinal flora of children with HSP was dysregulated, and the decrease of B/E value was more obvious in children with HSPN; Gd-IGA1, TGF-β1 and IGF-1 were all involved in the occurrence and development of HSPN, which may have a certain correlation to intestinal flora dysregulation