Abstract: Objective To analyze the correlation between 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 HAP children who were admitted into Department of Pediatrics, Suqian Hospital of Nanjing Gulou Hospital Group from January 2018 to May 2020 were enrolled into the current study. According to the impact on the kidneys, they were divided into two groups: a normal HSP group (n=73) and a Henoch-Schonlein purpura nephritis (HSPN) group (n=55). Meanwhile, another 50 healthy children were selected as a 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. The enzyme-linked immunosorbent assay was used to detect the 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 Compared with the control group, the HSP group presented remarkable decreases in the number of total intestinal bifidobacterium and B/E value, and increases in the number of Escherichia coli and the levels of serum Gd-IgA1, TGF-β1 and IGF-1 (P<0.05). Compared with the normal HSP group, the HSPN group showed significant decreases in the number of intestinal bifidobacterium and B/E, and the number of Escherichia coli and the levels of serum Gd-IGA1, TGF-β1 and IGF-1 (P<0.05). According to Pearson correlation analysis,t 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, respectively, P<0.05). Conclusions The intestinal flora of children with HSP was dysregulated, and the decrease of B/E value is more obvious in children with HSPN. Gd-IGA1, TGF-β1 and IGF-1 are all involved in the pathogenesis of HSPN, which may have a certain correlation to intestinal flora dysregulation.