特发性血小板减少性紫癜患者血小板生成素和幽门螺杆菌检测的临床意义

Clinical Significance of Thrombopoietin and Helicobacter Pylori in Patients with Idiopathic Thrombocytopenic Purpura

目的探讨特发性血小板减少性紫癜(ITP)患者血小板生成素(TPO)和幽门螺杆菌(HP)检测的临床意义。方法60例初治ITP患者,在接收治疗前采用双抗体夹心酶联免疫吸附法(ELISA)检测血清TPO水平,计数骨髓涂片的平均巨核细胞数量,用14C尿素呼气试验检测患者HP感染情况。结果对治疗反应无效的ITP患者,其TPO水平明显高于治疗有效者及对照组(P<0.05),后两者间无显著差异(P>0.05);巨核细胞计数无效者显著低于有效者(P<0.01);60例ITP患者共检出HP感染30例,与对照组(17例)无显著性差异(P>0.05),但是在13例治疗无效的ITP患者中HP阳性占10例,明显高于对照组(P<0.05),进行抗HP治疗后血小板(PLT)明显升高者6例。结论ITP患者中,血清高水平TPO、骨髓低巨核细胞计数可能预示治疗困难;对常规治疗无效者,HP可能参与其发病,部分抗HP治疗有效。

Objective To investigate the clinical significance of thrombopoietin（TPO） and Helicobacter pylori（HP） in patients with idiopathic thrombocytopenic purpura（ITP）.Methods 60 patients with newly diagnosed ITP,their serum TPO concentration were detected by double-antibody sandwich enzyme-linked immunosorbent assay（ELISA）;and the bone Marrow megakaryocytes were recorded;HP was detected by 14^C urea breath test.The control group of 40 cases was also detected by above methods.Results the TPO of ineffective group with ITP were significantly higher than that of the effective group and the control group（P〈0.05）;The megakaryocytes of ineffective group were significantly lower than that of the effective group（P〈0.01）.HP was found in 30 of 60 patients,17 was found of 40 in the control group（P〉0.05）.But HP was found in 10 of 13 patients of ineffective group,that was significantly higher than control group（P〈0.05）,the platelet counts of 6 significantly increased in 10 patients after anti-HP treatment.Conclusion High levels of serum TPO and lower megakaryocyte counts may indicate that the treatment of ITP is more difficult;HP may be involved in its pathogenesis,anti-HP treatment is effective in part of ITP.