慢性特发性血小板减少性紫癜和幽门螺杆菌感染的临床分析

The Clinic Analysis of Chronic Idiopathic Thrombocytopenic Purpura and the Effects of Hpylori

目的:探讨糖皮质激素联合抗HP治疗对HP阳性CITP患者的临床疗效。方法:通过^(14)C-尿素呼气试验和血清幽门螺杆菌抗体检测明确HP感染情况。对阳性者行抗HP联合激素治疗,阴性者单纯行激素治疗。比较两组的一般情况、治疗前后血小板的数量变化及疗效。结果:HP感染率为69%。HP清除率为79%。阳性组和阴性组平均年龄分别为(45.2±13.6)岁,(30.7±15.8)岁(P<0.05)及平均骨髓巨核细胞数分别为(269.3±231.2)个/片和(109.7±94.9)个/片(P<0.05)。阳性组联合抗HP治疗CITP总有效率为92%。高于阴性组的63%(P<0.05)。根除HP成功组平均血小板计数高于根除HP失败组和HP阴性组(P<0.05),血小板升高幅度也高于其他两组(P<0.05)结论:1.CITP患者HP感染率高于正常人群。2.HP阳性CITP患者平均年龄及骨髓巨核细胞代偿性增生程度高于HP阴性者。3.激素联合抗HP治疗HP阳性CITP患者疗效优于单纯应用激素的HP阴性者。根除HP治疗有助于HP阳性CITP患者血小板数的提升。

Objective：Determine the effects of Hpylori eradication treatment on CITP. Methods： To determine the HP infection underwent 14^C-urea breath test and HP antigen test. Hpylori-positive patients consented to glucocortieoid with eradication treatment,four weeks after eradication treatment.Only glucocorticoid to H.pylori-negative patients. Analysis the curative effect,changes of platelet count of two groups. Results：The incidence of H.pylori infection was 69%, H.pylori eradication rate was 79%.The mean age of H.pylori-positive patients and H.pylori- Negative patients were （45.2±13.6）, （30.7±15.8） （P〈0.05）, and mean megakaryocytes counts were （269.3±231.2） vs （109.7 ± 94.9） （P〈0.05） .The total effective rate of H.pylori-positive group was 92%,singnificantly higher than that in H.pylori-negtive group（with total effective rate 63 %）, Patients in whom H.pytori was eradicated had a significant increase in platelet counts,also higher than other groups （P〈0.05） . Conclusions： The incidence of H.pylori infection was higher than the incidence in the general populartion.The H.pylori-positive group had a higher mean age and countsof hyperplastic bone marrow megakaryocytes.It is significant useful to increas the platelets count of CITP patients combined with HP eradication treatment.