幽门螺旋菌根治与特发性血小板减少性紫癜的临床研究

The Clinic Research of Helicobacter Pylorus and Idiopathic Thrombocytopenicpurpura

目的研究根除幽门螺旋菌后成人特发性血小板减少性紫癜(ITP)患者血小板恢复情况。方法 2009年1月至2013年12月在血液科住院的幽门螺旋菌阳性的成人ITP患者56例,随机分为试验组和对照组。试验组予以强的松1mg/(kg·d),并进行4周根除幽门螺旋菌治疗(阿莫西林1.0 g,2次/d,7d,呋喃唑酮0.1,2次/d,7d,雷贝拉唑20mg q,2次/d,4周);对照组仅服用强的松1mg/(kg·d),血小板恢复后将激素逐渐减量持续治疗3月,并观察治疗后6月和12月时复发情况。结果试验组有效率为68.5%,对照组有效率为35.7%;试验组内根除幽门螺旋菌成功患者治疗3月时的血小板平均值为85×109/L,根除失败患者3月时的血小板平均值为60×109/L;试验组随访12月总复发率为14.2%,对照组复发率为39.2%;56例患者中有2例合并胃溃疡,其中病理检验提示活动期的患者较非活动期患者血小板恢复好。结论根除幽门螺旋菌是合并HP感染ITP患者行之有效的办法,病理检验可以预测对根除细菌后血小板的恢复情况。

Objective To study the platelet recoveryment of adult idiopathic thrombocytopenicpurpura after eradication of Helicobacter pylorus. Methods 56 ITP patients between January 2009 and December 2013 are divided to two groups: the trial group( treating patients with adrenal cortical hormone cortin and anti-helicobacter pylorus treatment) and compared group( only with adrenal cortical hormone cortin),we compare the efficiency of two groups,the quantity of the platelet between the group which succeeded in eradicating the Hp and the group which failed in eradicating Hp; the recurrence rate of two groups; 2 patients who at the same time had stomach pains benefited from the research,but wo observed that the patient whose stomach histological parameters of activity is more severe recovery better than the one of less severe. Results The efficiency of the trial group is 68. 5%,the compared group is 35. 7%; After the eradication of Hp,the average plates of the patients in the trial group when the treatment of 3months is 85 × 109/ L,and the compared group is 60 × 109/ L. After 12 months investigation,the relapse rate of the trial group is14. 2%,while the compared group is 39. 2%. 2 of the 56 patients who at the same time had stomaeh ulcer benefited from the research,but we obsorved that the patients whose stomaeh histological parameters of aetivity is more severe recaeny better that the one of less sevesre. Conclusion Eradication of Hp is helpful for ITP patients who is Hp( +),we can also predict the recoveryment of platelet using the histological methods.