抗幽门螺杆菌治疗在特发性血小板减少性紫癜中的作用  

Clinical Study of Helicobacter Pylori Eradication in Patients With Idiopathic Thrombocytopenic Purpura

作　　者：李岭[1] 陈艳华[1] 刘拥征[1] 陈方志[2] 

机构地区：[1]南华大学第二附属医院血液内科,湖南衡阳421001 [2]南华大学第二附属医院消化内科,湖南衡阳421001

出　　处：《南华大学学报（医学版）》2009年第5期544-546,共3页Journal of Nanhua University(Medical Edition)

摘　　要：目的探讨特发性血小板减少性紫癜(ITP)与幽门螺杆菌(HP)的关系及抗HP治疗在ITP患者中的意义。方法选取71例确诊为ITP的初治患者,采用14碳尿素呼气试验(14C-UBT)分为HP阳性者48例和HP阴性者23例。HP阳性者随机分为联合用药组24例,泼尼松组24例,HP阴性者23例为对照组,联合用药组予抗HP治疗及泼尼松治疗,泼尼松组、对照组仅用泼尼松治疗。结果3组患者治疗后2周、4周、3个月血小板计数均呈递增趋势,联合用药组增加最明显,同时与泼尼松组、对照组比较差异均有显著性(P<0.05),但泼尼松组和对照组血小板计数差异无显著性(P>0.05);联合用药组、泼尼松组、对照组总有效率分别为88.67%、62.50%、56.52%,联合用药组总有效率均明显高于泼尼松组(P<0.05)、对照组(P<0.01);泼尼松组和对照组总有效率比较差异无显著性(P>0.05)。结论HP感染与特发性血小板减少性紫癜的发病有一定的相关性,对HP阳性的ITP患者行抗HP治疗能提高临床疗效。Objective To study the relationship between idiopathic thrombocytopenic purpura（ITP） and Helicobacter pylori （HP） and to evaluate the effect of Hp eradication in the ITP. Method 71 patients diagnosed as ITP were divided into HP - positive group148 eases） and HP - negative group（23 cases） by 14C - urea breath test（ 14C - UBT）. HP - positive group patients were then randomly divided into combined treatment group （24 cases ） , prednisone group （24 cases）. Combined treatment group were administered by Helicobaeter pylori eradication and prednisone, prednisone group and HP -negative group （control group ） only with prednisone therapy. Result Three groups all show a progressive trend of platelet count after treatment of 2 weeks, 4 weeks and 3 months; At the same cure time, the number of platelet was increased more obviously in combined treatment group, which had more significant differences than prednisone group and control group （ P 〈 0.05 ） , and there had no significant difference between prednisone group and control group （ P 〉 0.05 ） ; The total effective rate were 88.67% （ combined treatment group ） , 62.50% （ prednisone group ） , 56.52% （ control group ）, and the total effective rate of combined treatment group was significantly higher than prednisone group （ P 〈 0.05 ） and control group （ P 〈 0.01 ） ; prednisone group and control group had no significant differences （ P 〉 0.05 ）. Conclusion There was some relevance between HP infection and incidence of idiopathic thrombocytopenic purpura, eradication of Helicobacter pylofi for the HP - positive ITP patients can improve clinical efficacy.

关 键 词：特发性血小板减少性紫癜 幽门螺杆菌 抗幽门螺杆菌治疗 

分 类 号：R554.6[医药卫生—血液循环系统疾病]