成人特发性血小板减少性紫癜与幽门螺杆菌CagA蛋白的关系

Relationship between idiopathic thrombocytopenic purpura and helicobacter pylori CagA protein in adults

目的了解成人特发性血小板减少性紫癜(idiopathic thrombocytopenic purpura,ITP)与幽门螺杆菌(helicobacter pylori,Hp)CagA蛋白的关系。方法采用14C尿素呼吸试验对正常成人和ITP患者进行Hp检测后,对Hp阳性的ITP患者进行CagA蛋白抗体检测。依据急性ITP,慢性ITP,难治性ITP对ITP患者进行分类。结果 223例正常患者中123例Hp阳性,感染率为55.2%,而CagA蛋白抗体阳性为42例,占34.1%。278例ITP患者中Hp阳性176例,感染率63.3%,其中CagA蛋白抗体阳性83例,占47.2%,ITP患者的Hp感染率与正常人相似,但CagA蛋白抗体阳性率显著高于正常人(P<0.05)。Hp感染率及CagA蛋白抗体阳性率在急性ITP患者中分别为62.2%和46.4%,慢性ITP为63.2%和47.0%,难治性ITP为64.7%和48.5%,比较显示不同类型的ITP患者Hp感染率及CagA抗体阳性率差异无统计学意义(P>0.05)。结论纳入研究的ITP患者的Hp感染率与正常人相似,但CagA蛋白抗体阳性率明显高于正常人,提示CagA蛋白在成人ITP的发生发展中具有一定作用。进一步分析也显示不同类型的ITP患者Hp感染率及CagA蛋白阳性率差异无统计学意义。

Objective To investigate the relationship between idiopathic thrombocytopenic purpura（ITP）and helicobacter pylori（Hp）CagA protein in adults.Methods Normal adults and adults with ITP were detected by 14C urea breath test.Then people who were positive in 14C urea breath test were detected CagA protein antibody.Results Among the 223 normal adults,123 were HP-positive（55.2%）and 42 were CagA antibody-positive（34.1%）.Among the 278 ITP patients,176 were HP-positive（63.3%）and 83 were CagA antibody-positive（47.2%）.The infection rate of Hp in ITP patients was similar to that of normal adults.But the antibody of CagA protein in ITP patients was significantly higher than that in normal adults（P0.05）.The infection rate of Hp and positive rate of CagA antibody in patients with acute ITP were 62.2% and 64.7% respectively,those in patients with chronic ITP were 63.2% and 47.0% respectively,and those in patients with refractory ITP were 64.7% and 48.5% respectively.There was no statistical significance in patients with different types of ITP（P0.05）.Conclusion The study has shown there is no significant difference between ITP and normal adults with Hp,but CagA protein antibody in patients with ITP is higher than that in normal adults.CagA protein seems to play a role in the development of ITP.Further analysis shows there is no statistical significance in patients with different types of ITP.