幽门螺旋杆菌与血小板减少的相关性研究

目的:探讨幽门螺旋杆菌(Helicobacter Pylori,Hp)感染与慢性免疫性血小板减少性紫癜(Chronic Idiopathic Thrombocytopenic Purpura,CITP)之间的关系及清除Hp对CITP的疗效。方法:用14C尿素呼气试验或胃镜取材快速尿素酶试验检测60例CITP患者,并选择20例健康人为健康对照组;将60例受检者中的43例Hp(+)CITP患者分为2组:治疗组22例,应用糖皮质激素+抗Hp治疗;对照组21例,单用糖皮质激素。结果:(1)Hp感染率比较,CITP组为43例,占71.67%,健康组为11例,占55.00%,两组比较P>0.05;(2)疗效:①Hp清除率:20例Hp(+)CITP患者经抗Hp治疗后,Hp清除者19例(95.55%),在接受Hp清除疗法者中未出现严重不良反应或血小板降低;②两组疗效比较:治疗组总有效率95.55%(21/22),对照组总有效率66.67%(14/21)两组比较P<0.05;6月内复发率治疗组9.52%(2/21),对照组42.86%(6/14)P<0.05。结论:CITP患者Hp感染率与健康组无统计学差异,对合并Hp感染的CITP患者在糖皮质激素治疗的同时给予抗Hp治疗,将提高疗效、减少复发。

The Research of Relationship Between the Helicobacter Pylori and Chronic Idiopathic Thrombocytopenic Purpura

Objective:To investigate the relationship between the Helicobacter Pylori(Hp)infection and chronic idiopathic thrombocytopenic purpura (CITP) and the curative effect in patients with CITP after cleaning up Hp.Methods: 60 patients with CITP and 20 health control cases were checked by 14C urea breath test or rapid urease test.43 patients with(+)Hp CITP were divided into 2 groups.22 patients in treatment group were treated with glucocorticoid and anti-Hp and 21 in control only with glucocorticoid.Results:1.Hp infection rate comparison: the patients with(+)Hp were 43 out of 60(71.67%) in CITP group and 11 out of 20(55.00%) in health group,(P>0.05).2.the curative effect: ① The rate of cleaning up Hp: 19 out of 20(95.55%) patients with(+)Hp CITP were cleaned up Hp after anti-Hp treatment.There were no serious adverse effections or platelet depressing.② The curative effect of 2 groups comparison: the total effective rate was 95.55%(21/22) in treatment group and 66.67%(14/21) in control(P<0.05),the relapse rate was 9.55%(2/21)in treatment group and 46.86%(6/14) in control within 6 months.Conclusion: There are no significant differences for the Hp infection rate between the CITP patients and health group and the treatment to patients with(+)Hp CITP using glucocorticoid and anti-Hp can raise curative and decrease relapse.