幽门螺旋杆菌感染与特发性血小板减少性紫癜相关性研究

Research on relationship between H.pylori infection and idiopathic thrombocytopenic purpura

目的探讨幽门螺旋杆菌(HP)在特发性血小板减少性紫癜(ITP)发病中的意义,观察对ITP患者抗HP治疗的疗效。方法对138例ITP患者进行HP检测,阳性患者81例随机分为A、B两组,A组(42例)给予糖皮质激素及抗HP治疗;B组(39例)单用糖皮质激素治疗,观察两组疗效。结果 138例ITP患者中HP阳性者81例,阳性率58.7%;A组42例患者中治疗有效37例(88%),B组39例患者中治疗有效30例(76.9%),两组差异有统计学意义(P<0.05);两年内复发率A组21.3%,B组43.5%,差异有统计学意义(P<0.01)。A组中急性ITP17例,总有效率82%,慢性ITP25例,总有效率92%,差异有统计学意义(P<0.05)。结论 HP感染与部分ITP的发病密切相关,加用抗HP治疗可提高ITP疗效,降低复发率,尤其对慢性血小板减少性紫瘢(CITP)患者效果更好。

Objective To explore the significance of Helicobacter pylori infection in patients with idiopathic thrombocytopenic purpura（ITP）and observe the effect of HP eradication on the therapeutic efficacy of ITP patient.Methods 138 ITP patients were screened for Hp infection.ITP patients with Hp-positive were randomly divided into 2 groups（group A and group B）.The group A（n=42） received glucocorticoid and Hp eradication.The group B（n=39） received only glucocorticoid.The clinical efficacy was evaluated.Results Among the 138 ITP patients,81 patients（58.7%） were complicated with Hp infection.The effective rate in group A（88%） was significantly higher than that（75%） in group B（P〈0.05）.The recurrence rate in 2 years in group A（21.3%） was significantly lower than that（43.5%） in group B（P〈0.01）.Of all the 42 patients of group A,17 patients were diagnosed with acute IPT（AITP） with effective rate of 92%,and another 25 patients were diagnosed with chronic ITP（CITP） with effective rate of 92%.There were significant differences between two groups（P〈0.05）.Conclusion Hp infection is closely relevant to part of ITP.Hp eradication in ITP patients with Hp-positive can improve efficacy and reduce the recurrence,especially for the CITP patients.