幽门螺杆菌感染与慢性特发性血小板减少性紫癜相关性的临床初步探讨

目的 初步探讨幽门螺杆菌(Hp)感染与慢性特发性血小板减少性紫癜(ITP)的关系.方法 以查体人群(118例)和ITP患者(38例)作为研究对象.经血清Hp检查、13C呼气试验确定有无Hp感染,Hp阳性者测定抗CagA抗体滴度.Hp阳性ITP患者行Hp根除治疗并随访12周观察血小板是否增加.结果 入选查体人群118例,Hp阳性者79例,Hp阴性者39例.其外周血PIJT、WBC、RBC差异无统计学意义(P均＞0.05).ITP患者38例,Hp阳性22例,其中Caga阳性18例;Hp阴性16例.查体人群中,血清CagA阳性者29例.ITP患者中Hp阳性率为57.9%,查体人群中Hp阳性率为66.9%;二者阳性率相比,差异无统计学意义(Pearson Chi-square 1.032;P=0.310).而在Hp阳性者中,ITP患者CagA阳性率(81.8%)明显高于查体人群(36.7%),差异有统计学意义(Pearson Chi-square 14.074;P=0.001).ITP患者根治Hp后疗效观察:无效:12例,2例男性,4例cagA阴性.有效+显效10例,100%为女性,100%cagA阳性.治疗有效率45.5%.结论 正常人群感染Hp后,外周血白细胞、Hb、血小板无显著性改变.ITP患者与查体人群,二者Hp阳性率相比,差异无统计学意义.而在Hp阳性者中,ITP患者CagA阳性率明显高于查体人群.ITP患者,经抗Hp治疗后,部分治疗有效.随着随访时间的延长,经根治Hp治疗后,部分患者PLT水平逐渐回升,平均5周可恢复至正常范围.

Clinieni observation on relationship between Heficobacter Pvlori infection and chronic idiopathic thrombocytopenic purpura

Objective To investigate the relationship between Helicobacter Pylori(Hp)infection and idiopathic thrombocytopenic purpura(ITP).Methods The subjects who undertook checkup and ITP patients were taken into the study.The serological Hp antibody and 13C-urea breath test were conducted to confirm whether the patients were infected with Hp.Then anti-CagA antibody was examined in people with Hp infection.Patients with Hp Of 118 healthy Chinese people.79 were Hp positive and 39 were Hp negative.There Wash't a significant difference in positive and 18 were CagA positive.Of 118 healthy Chinese people,29 were CagA positive.Patients with Hp infection accounted for 57.9%in all ITP patients and compared with the prevalence in healthy population.there wasn't a significant difference(Pearson Chi-Square:1.032;P=0.310).However,in all the people with Hp infection,the prevalence of CagA in ITP patients was significantly higher than that in healthy people(Pearson Chi-Square:14.074;P=count increased,with effective rate of45.5%.However,it was no significant variety in 12 patients(2 male,4 CagAnegative).Conclusion In healthy population,there isn't a significant difference in PLT count,WBC count and RBC count between Hp positive group and Hp negative group.The prevalence of Hp infection isn't significantly different between healthy population and ITP patients.However,in all the people with Hp infection,the prevalence of CagA in ITP patients is significantly higher than that in healthy people.Some of ITP patients in whom Hp were eradicated have significant platelets count increased with follow-up going on,which will become normal on average of 5 weeks.