联合抗幽门螺杆菌治疗儿童免疫性血小板减少症的临床研究

目的：探讨免疫性血小板减少症（IT P）患儿感染幽门螺杆菌（Hp）的特点及抗感染治疗的意义。方法采用13 C尿素呼气试验检测142例ITP患儿和92例健康儿童Hp感染情况。将ITP患儿中97例阳性者分为两组：联合治疗组49例，应用糖皮质激素联合抗 H p治疗；单药治疗组48例，单用糖皮质激素治疗。分别检测两组治疗前后血小板相关参数、血小板相关抗体和淋巴细胞亚群的变化。结果 IT P患儿 Hp的感染率为69．7％，明显高于健康儿童（40．2％）。两组患儿治疗6个月后，联合治疗组患儿血小板计数、PCT、CD3＋、CD3＋CD4＋和CD3＋ CD4＋／CD3＋ CD8＋升高水平明显高于单药治疗组（P＜0．01），而MPV、PDW、PAIgG、PAIgA、CD3＋CD8＋下降水平均高于单药治疗组（P＜0．01）。结论 ITP患儿 Hp感染率高于健康儿童；Hp可能通过影响机体免疫功能参与了儿童ITP的发病和发展过程，联合抗 Hp治疗可改善ITP患儿机体免疫状态，提高治疗效果。

Clinical study on the anti-helicobacter pylori treatment on immune thrombocytopenia in children

Objective To explore the clinic character of immune thrombocytopenia (ITP) children infected with helicobacter py‐lori (Hp) and the effects of anti‐helicobacter pylori treatment on those children .Methods One hundred and forty‐two ITP children and 92 healthy children were conducted the 13C‐Urea breath test to determine the infections of Hp .The ITP children infected with Hp were divided into two groups :single drug group (48 cases ,treated only with corticosteroid ) and combined drugs group (49 ca‐ses ,treated with corticosteroid and anti‐helicobacter pylori treatment) .The platelet parameters ,platelet associated immunoglobulin and some lymphocyte subsets were analyzed .Results Ninety seven children infected with Hp were found in 142 ITP children (69 . 7% ) .In the mean time ,37 children infected with Hp were observed in 92 healthy children (40 .2% ) .After treatment of 6 months , the PLT ,PCT ,CD3+ ,CD3+CD4+ and CD3+ CD4+ /CD3+ CD8+ of ITP children in both group were increased ,and the increased degree of those parameters were much higher in combined drug group than those in single drug group (P< 0 .01) .However ,the MPV ,PDW ,PAIgG ,PAIgA and CD3+ CD8+ were more decreased than that of the single drug group(P<0 .01) .Conclusion The ITP children have a higher infection rate of Hp ,which may be involved in the pathogenesis of ITP .Anti‐helicobacter pylori therapy would improve the therapy efficacy of ITP children infected with Hp by improving their immunity .