幽门螺杆菌根除治疗对特发性血小板减少性紫癜患者疗效的影响

【目的】分析特发性血小板减少性紫癜（ITP）患者的幽门螺杆菌（Hp）感染情况，探讨Hp根除治疗对Hp感染的ITP患者疗效的影响。【方法】用^13C尿素呼气试验或胃镜取材快速尿素酶试验检测132例ITP患者的Hp感染情况，将132例受检者中80例Hp（＋）ITP患者随机分为两组，每组各40例：治疗组采用免疫加根除HP治疗，而对照组只采用免疫治疗，治疗前以及治疗后d14、第1、3、6个月检测两组患者的血小板数目并评估临床效果。【结果】132例ITP患者中有HP感染80例（60．6％），治疗组的40例中，成功根除HP29例（72．5％）。治疗后d14、第1、3、6个月血小板计数比较显示，治疗组明显高于对照组（P〈O．01）。治疗组的总有效率显著高于对照组（P〈0．05），治疗后随访1年，治疗组的总复发率明显低于对照组（P〈0．01）。【结论]Hp感染与ITP有关，部分Hp（＋）患者根除Hp治疗有效。根除Hp为临床治疗ITP提供了一条新的途径。

Effect of Helicobacter Pylori Eradication on the Therapeutic Efficacy of Patients with Idiopathic Thrombocytopenic Purpura

Objective] To analyze the Helicobacter pylori（Hp） infection in patients with idiopathic throm- bocytopenic purpura（ITP） and to explore the effect of HP eradication on the therapeutic efficacy of ITP patients. Methods]A total of 132 1TP patients were screened for Hp infection by using 13C urea breath test or rapid urease test. Among 132 subjects, 80 ITP patients with Hp-positive were randomly divided into 2 groups. The treatment group（ n = 40） received immunotherapy and Hp eradication. The control group（ n = 40） received only immunotherapy. The platelet of two groups was counted before treatment and 14th day, 1st, 3rd, 6th month after treatment. The clinical efficacy was evaluated. Results] Among 132 ITP patients, 80 patients（60.6%） were complicated with Hp infection. Hp was eradicated successfully in 29 cases（72.5%） in the treatment group. The platelet number in the treatment group at 14th day, 1st, 3rd and 6th month after treatment was obviously higher than that in the control group（ P 〈0.01）. The total effective rate in the treatment group was significantly higher than that in the control group （ P 〈0. 05）. After one year of follow-up af ter treatment, the total recurrence rate in the treatment group was significantly lower than that in the control group（ P 〈0.01）. Conclusion] Hp infection is relevant to ITP. The eradication of Hp is effective for some ITP patients with Hp-positive. Hp eradication may be a new approach for the clinical therapy of ITP.