根除幽门螺杆菌治疗儿童特发性血小板减少性紫癜的临床观察

目的了解幽门螺杆菌（HP）在儿童特发性血小板减少性紫癜（ITP）患者中的感染情况，观察根除HP治疗儿童ITP的临床效果。方法对267例ITP患儿进行13C尿素呼吸试验检测，将确诊HP感染的60例患儿随机分成研究组（30例）和对照组（30例）。研究组采用免疫加根除HP治疗，而对照组只采用免疫治疗，比较两组治疗前以及治疗后第7天、第1、2、3个月血小板的数目和临床效果。结果267例ITP患儿中有HP感染60例（22．5％），研究组的30例中，成功根除HP26例（86．7％）。治疗后第7天、第1、2、3个月血小板的数目比较显示，研究组明显高于对照组（P〈0．01）。临床效果比较显示研究组的疗效显著高于对照组（P〈0．01）。结论本研究中，HP的感染率为22．5％，采用HP根除治疗的根除率为86．7％，根除HP治疗有助于HP感染的ITP患儿的血小板恢复。

Clinical observation on helicobactor pylori eradiating therapy in children with idiopathic thrombocytopenic purpura

Objective To investigate the status of helicobactor pylori （HP） in children with idiopathic thrombocytopenic purpura（ITP）, and observe the clinical effect on HP eradiating therapy in children with ITP. Methods 267 children with ITP were detected by 13C urea breath test. The children who had positive results were randomly divided into study group （n= 30） and control group （n= 30）. The children were treated with immunotherapy and HP eradiating therapy in study group. The children were only treated with immunotherapy in control group. Clinical effects and the platelets before treatment and in the 7th day, 1st month, 2nd month, 3rd month after treatment were compared between groups. Results 60 of 267 children with ITP were positive for HP infection （22.5%）. The clearances of HP were a- chieved in 26 out of 30 children with ITP in study group （86.7%）. The analysis showed the platelets in the study were higher than in the control group （P〈0. 01） in the 7th day, 1st month, 2nd month, 3rd month after treatment. The analysis of clinical effects of children showed the study group were better than the control group（P〈0. 01）. Conclusions The study had shown the prevalence of HP infection in ITP children was 22.5%. The bacterium eradication were obtained in 26 of 30 HP positive children （86.7%） in study group, which was significant to increase the platelets count of ITP children combined with HP eradication treatment.