幽门螺杆菌和特发性血小板减少性紫癜的关系

Helicobacter Pylori and Idiopathic Thrombocytopenic Purpura

特发性血小板减少性紫癜(ITP)由多种原因引起,近年来有学者发现幽门螺杆菌(Hp)感染和ITP有一定关系。研究表明,Hp感染导致ITP的可能机制:一是分子模拟学说,即Hp抗体与血小板糖抗原有交叉反应,而导致血小板破坏较少。Hp提高噬菌血小板作用或诱导血小板聚集加速血小板破坏。二是细胞因子改变,Hp感染诱发了Th1为主的免疫反应,而产生的相应细胞因子可能促使ITP发展。但也有学者认为Hp和ITP没有关系,引起这些研究差异的原因是宿主遗传背景不同、Hp株差异性导致抗Hp治疗疗效不同以及研究的地理位置的差异。

There are many causes for idiopathic thrombocytopenic purpura（ITP）.In recent years,some researchers have found that the eradication of Helicobacter pylori（Hp） infection has been variably associated with a platelet response in patients with ITP.Many hypotheses have been advanced regarding the mechanisms by which Hp may cause ITP.One of them is molecular mimicry as Hp can induce antibody production in response to antigens that cross-react against various platelet glycoprotein antigens and lead to thrombocytopenia.Secondly,Hp can significantly enhance platelet phagocytosis,induce platelet aggregation,and lead to the decrease of platelets.Cytokine change,Hp-induced alterations in T helper 1-type immune responses,and cytokine profiles may promote the development of ITP.However,some authors believe that there is not relation between Hp and ITP,to which many factors may lead.The underlying causes include the genetic background of t host,Hp strain,and geographic variation.