胃肠外疾病患者幽门螺杆菌感染分析

目的检测幽门螺杆菌（Helicobacterpylori，H．pylori）在胃肠外疾病患者中的感染率及其分布特征，探讨其与胃肠外疾病发病的相关性，以期在疾病预防及临床治疗中发挥指导作用。方法对1530例特发性血小板减少性紫癜、糖尿病、结缔组织病、肝硬化、过敏性紫癜及其他胃肠外疾病患者进行14C-尿素呼气试验检测。结果1530例胃肠外疾病患者中有1140例14C-UBT结果阳性，感染率74．5％。特发性血小板减少性紫癜、糖尿病、结缔组织病、过敏性紫癜组H．pylori感染率均高于健康人（P〈0．05），肝硬化患者H．pylori感染率与健康人无明显差异。特发性血小板减少性紫癜、糖尿病、结缔组织病等合并慢性胃炎或消化性溃疡的病例H．pylori感染率较单纯慢性胃炎或消化性溃疡患者高（P〈0．05），而肝硬化及过敏性紫癜组则无明显差异。在特发性血小板减少性紫癜等胃肠外疾病患者中联合抗日．pylori治疗疗效优于单纯治疗原发病。结论H．pylori感染可能在消化道以外疾病的发生发展过程中起重要作用，但是否为相关胃肠外疾病发病的独立危险因素需要进一步证实。

Analysis of infection of Helicobacter pylori in patients with extra-gastrointestinal diseases

Objective To evaluate the different infection rate of H. pylori in patients with extra-gastrointestinal diseases and investigate its correlation with the pathogenic process of the latter. Methods All 1 530 patients with extra-gastrointestinal diseases such as idiopathic thrombocytopenic purpura（ ITP）, diabetes mellitus, connective tissue disease, hepatic cirrhosis, or Henoch-Schonlein purpura were detected by 14C-urea Breath Test. Results Among all these patients,there were 1 140 patients infected with H. pylori, the positive rate was 74.5%. In patients with idiopathic thrombocytopenic purpura, diabetes mellitus, or connective tissue disease or Henoch-Schonlein purpura, the positive rate of H. pylori was higher than that in healthy people （P 〈 0.05）. But in the patients with hepatic cirrhosis, there were no significant difference between them and healthy people （P 〉 0.05）. In patients with chronic gastritis or peptic ulcer accompanied by idiopathic thrombocytopenic purpura, diabetes mellitus, or connective tissue disease, the positive rate of H. pylori was higher than that in patients simply with chronic gastritis or peptic ulcer （P 〈 0.05 ）. But in the patients with chronic gastritis or peptic ulcer accompanied by hepatic cirrhosis, or Henoch-Schonlein purpura, there were no this significant difference. Eradication of H. pylori was proved more effective in increasing platelet count in H. pylori-positve patients with chronic ITP than simple treatment of primary affection. Conclusion H. pylori may play an important role in the nosogenesis and development of extra-gastrointestinal diseases. Whether or not it is an independent risk factor of extra-gastrointestinal diseases, which need to be further confirmed.