根除幽门螺杆菌在特发性血小板减少性紫癜治疗中的临床意义

Clinical Significance of Helicobacter Pylori (Hp) Eradication in Patients with Idiopathic Thrombocytopenic Purpura

目的探讨幽门螺杆菌(helicobacter pylori,Hp)感染在特发性血小板减少性紫癜(idiopathic thrombocytopenic purpura,ITP)中的发生率及清除Hp对ITP疗效的影响。方法用14C尿素呼气试验或胃镜取材快速尿素酶试验检测88例ITP患者的Hp感染情况,并选择50名健康体检者作为健康对照组。将88例受检者中的60例Hp(+)ITP患者随机分为2组:治疗组30例,应用糖皮质激素+抗Hp治疗,对照组30例,单用糖皮质激素。结果 ITP组Hp感染率为68.1%,而健康对照组Hp感染率46.1%,两组差异有显著性(P<0.05)。治疗组30例Hp(+)患者经抗Hp治疗后总有效率90%(28/30),对照组总有效率63%(19/30),两组比较P<0.05;1年内复发率治疗组4例(13.3%),对照组14例(46.7%),两组比较P<0.05。结论 ITP患者有高Hp感染率,抗Hp治疗可作为Hp阳性ITP患者的常规治疗方法之一,并可减少其复发。

Objective To investigate the incidence of helicobacter pylori （Hp） infection in the patients with ITP and the changes of ITP effect of Hp eradication. Methods Hp infection were examed in 88 ITP patients using ^14C urea breast test or rapid urease test, and the control group is composed of 50 health cases. 60 ITP patients with Hp infectd were randomly divided into treatment group and control group. Patients （30） in treatment group were received Hp eradication and glucocorticoid therapy. Others were given single glucocorticold therapy. Results The Hp infection rates were 68.1% in treatment group and 46.1% in health control group （ P 〈 0.05 ）. Hp positive patients （30） in treatment group were therapied by Hp eradication. We found that the total effective rate were 90% （28/30） in treatment group and 63% （19/30） in control group. And the recurrence rate in one year were 13.3% （4/30） in treatment group and 46.7% （14/30） in control group （P 〈 0.05）. Conclusion ITP patients have a higher infective rate than other diseases. Hp eradication may be a new gateway for ITP patients with Hp infection to reduce relapse.