儿童免疫性血小板减少症与幽门螺杆菌感染

Relationship between pediatric immune thrombocytopenia and Helicobacter pylori infection

目的探讨幽门螺杆菌(Hp)感染与儿童免疫性血小板减少症(ITP)发病的关系。方法应用酶联免疫法检测54例ITP患儿粪便Hp抗原,观察Hp抗原阳性与阴性患儿的临床表现、血小板减少程度及对治疗的反应。结果 54例患儿,Hp阳性率19%(10例),不同发病年龄患儿阳性率差异无显著性。47例急性ITP患儿中Hp阳性9例(19%),治疗后血小板恢复正常平均需7.3 d;38例Hp阴性患儿血小板恢复正常平均需5.1 d,两组间差异无显著性(P>0.05)。慢性ITP患儿Hp阳性率14%,与急性ITP差异无显著性。结论未发现ITP患儿Hp感染率高于一般人群;Hp阳性率与患儿年龄无明显相关;Hp感染不影响ITP患儿对治疗的反应。

Objective Immune thrombocytopenic purpura （ITP） is an autoimmune bleeding disease, and its pathogenesis has not been clear yet. Helicobacter pylori （Hp） infection has been recog- nized as one of the causes of ITP in adults. This study is to investigate the correlation between HP infection and pediatric ITP. Methods ELISA was used to detect Hp infection in feces samples in 54 children with ITP. Their clinic data were analyzed as well. All patients received glucocorticoid therapy, and those who had platelet counts less than 10 109/L or apparent mucosal bleeding received I^IG treatment additionally. Patients with Hp infection did not receive any specific therapy. Results The median age of all patients （22 girls, 32 boys） was 4 years old. In acute ITP group （47 patients）, 19% cases were Hp positive; in chronic ITP group （7 patients）, 14% cases were Hp positive. There was no significant difference between two groups （P 〉 0.05 ）. Conclusions The Hp positive rate in pediatric ITP patients was lower than that in adult patients, and there is no correlation between Hp infection and the therapeutic efficacy of pediatric ITP.