幽门螺杆菌检测在儿童过敏性紫癜诊治中的临床价值

Clinical value of elicobacter pylori detection in diagnosis and treatment of henoch-schonlein purpurapurpura children

目的通过对过敏性紫癜(HSP)患儿进行幽门螺杆菌(Hp)检测,探讨过敏性紫癜的发病与幽门螺杆菌感染的关系。方法 82例过敏性紫癜患儿作为观察组,60例门诊健康体检儿童作为对照组,均进行幽门螺杆菌抗体(Hp-Ig G)检测及14C尿素呼气试验。将51例幽门螺杆菌感染阳性的过敏性紫癜患儿随机分为A组(23例)和B组(28例),A组给予常规治疗,B组在常规治疗的基础上给予抗幽门螺杆菌治疗,疗程均为2周。对治愈患儿随访6个月后,比较临床疗效及复发情况。结果观察组幽门螺杆菌阳性率(62.2%)高于对照组(35.0%),差异有统计学意义(P<0.01)。经过2周的治疗,B组总有效率(92.9%)高于A组(60.9%),差异有统计学意义(P<0.01)。A组10例治愈患儿随访6个月,7例(70.0%)复发;B组19例治愈患儿随访6个月,4例(21.1%)复发;B组复发率低于A组,差异有统计学意义(P<0.01)。结论幽门螺杆菌感染可能是过敏性紫癜发病的诱发因素之一,尤其是腹型过敏性紫癜与幽门螺杆菌感染具有相关性,抗幽门螺杆菌三联疗法可提高过敏性紫癜的临床疗效,降低复发率。

Objective To explore correlativity of anaphylactoid purpura and helicobacter pylori infection by helicobacter pylori（Hp） detection to henoch-schonlein purpura（HSP） children. Methods There were 82 henoch-schonlein purpura children as observation group, and 62 health examined children in outpatient as control group. Both groups received helicobacter pylori antibody（Hp-Ig G） detection and 14 C urea breath test. A total of 51 henoch-schonlein purpura children with helicobacter pylori infection positive were randomly divided into group A（23 cases） and group B（28 cases）. The group A received conventional therapy, and group B received anti helicobacter pylori therapy on the basis of group A. Both groups had 2 weeks treatment. Comparison were made on clinical effect and recurrence in 6 months follow-up for cured children. Results The observation group had higher helicobacter pylori positive rate（62.2%） than control group（35.0%）, and the difference had statistical significance（P〈0.01）. Group B had higher total effective rate（92.9%） than group A（60.9%） after 2 week treatment, and the difference had statistical significance（P〈0.01）. Group A had 10 cured cases, with 7 recurrence cases（70.0%） after 6 month follow-up, and group B had 19 cured cases, with 4 recurrence cases（21.1%）. The group B had lower recurrence rate than group A, and the difference had statistical significance（P〈0.01）. Conclusion Helicobacter pylori infection maybe one of the inducing factors of henoch-schonlein purpura, especially to abdomen type of henoch-schonlein purpura. Anti helicobacter pylori triple therapy can increase the clinical effect of henoch-schonlein purpura, and decrease recurrence rate.