抗幽门螺杆菌治疗用于特发性血小板减少性紫癜的疗效观察

目的探讨抗幽门螺杆菌（HP）在特发性血小板减少性紫癜（ITP）治疗中的作用。方法145例HP阳性ITP患者根据血小板计数分为血小板小于50×10^9及血小板大于50×10^9两组。血小板小于50×10^9／LHP阳性患者95例，按人院顺序随机分为联合治疗组与单用糖皮质激素组。联合治疗组给予根除HP及糖皮质激素治疗，单用糖皮质激素组未给予根除HP治疗，其余治疗同联合治疗组。血小板大于50×10^9／LHP阳性、无明显出血征象者50例，按入院顺序随机分为抗HP治疗组与对照组。抗HP治疗组进行单纯正规抗HP治疗，对照组未用任何药物治疗，定期复查血常规。结果联合治疗组总有效率（92％）明显高于单用糖皮质激素治疗组（75％）（X2=5．01，P〈0．05），2年内复发率（19％）明显低于单用糖皮质激素组（49％）（x2=9．69，P〈0．01）。单纯根除HP治疗对ITP患者有一定疗效。结论根除HP是合并HP感染的ITP患者行之有效的治疗方法。

Clinical effect of eradication of helicobacter pylori in patients with idiopathic thrombocytopenic purpura

Objective To investigate clinical effect of eradication of helicobacter pylori in patients with idiopathic thrombocytopenic purpura(ITP). Methods 145 cases with HP-positive ITP paitients were divided into two groups( platelet counts results ＜ 50 × 109/L and platelet counts results ＞ 50 × 109/L). 95 cases with platelet counts ＜50 × 109/L were divided into two groups and treated with prednisone and Hp eradication(48 cases) or with prednisone without Hp eradication(47 cases). 95 cases with platelet counts ＞ 50 × 109/L were divided into two groups and treated with Hp eradication 25 cases)or follow-up without any treatment(25 cases). Results The total effective rate in group treated with prednisone and Hp eradication was significantly higher than that in group with prednisone without Hp eradication( 92％ vd 75％, x2 ＝ 5.01 ,P ＜ 0.05 ). The recurrence rate in two year in group treated with prednisone and Hp eradication was significantly lower than that in group with prednisone without Hp eradication( 19％ vs 49％,x2 ＝ 9. 69, P ＜ 0. 01 ). HP eradicatiaon single can improve platelet counts in HP-positive ITP paitients.Conclusion The detection and eradication of H pylori infection should be considered in patients with ITP. H. pylori eradication could be used for initial treatment in HP-positive ITP paitients.