幽门螺杆菌在儿童特发性血小板减少性紫癜中的临床意义  

Clinical Significance of Helicobacter Pylori in Children with Idiopathic Thrombocytopenic Purpura

作　　者：唐瑛[1] 王书春 王鲁娟[1] 刘永[1] 王海英[1] 王占聚[1] 

机构地区：[1]潍坊医学院附属医院血液科,山东潍坊261000 [2]中国医学科学院血液病研究所、血液病医院,天津300110

出　　处：《中国实验血液学杂志》2013年第2期419-421,共3页Journal of Experimental Hematology

基　　金：潍坊市科技发展计划项目(编号201102054)

摘　　要：本研究旨在探讨幽门螺杆菌(helicobacter pylori,HP)在儿童特发性血小板减少性紫癜(ITP)中的临床意义。用13C尿素呼气试验检测92例ITP儿童患者的感染情况,并检测66名健康儿童作为对照组。将ITP患儿中68例阳性者随机分为2组:复合用药治疗组34例,应用糖皮质激素+抗菌治疗;单药治疗组34例,用糖皮质激素治疗。结果表明:ITP患儿HP的感染率为74.7%,明显高于对照组(39.4%)(P<0.05)。ITP患儿经治疗后,单药治疗组的总有效率(73.5%)明显低于复合用药治疗组的总有效率(94.1%)(P<0.05);治疗组1年内的复发率(17.6%)明显低于单药治疗组(47.1%)(P<0.05);治疗过程中患儿外周血血小板计数均呈逐渐上升趋势,在相同时间点,复合用药治疗组血小板计数明显高于单药治疗组(P<0.01)。结论:ITP患儿HP感染率高于健康儿童,HP可能参与了儿童ITP的发病过程,抗HP治疗可提高ITP患儿的治疗效果,降低其复发率。This study was aimed to investigate the clinic significance of helicobacter pylori （HP） in children with idiopathic thrombocytopenic purpura（ITP）. The infection of HP in 92 ITP children was determined by ^13C-Urea Breath Test, the same test was also performed on 66 healthy children. The 68 children infected with HP were randomly divided into 2 groups： single drug group treated only with corticosteroid and; combined drug group treated with corticosteroid and anti-helicobacter pylori treatment. The results showed that 68 patients infected with HP were found in 92 ITP children（74.7% ）, 26 patients infected with HP were observed in 66 healthy children （39.4%）, which was lower than that in ITP children （74.7 %, P 〈 0.05 ）. After anti-helicobacter pylori therapy, the total effective rate and cure rate of ITP patients increased respectively from 73.5% to 94.1%, and the total recurrence rate（ 17.0% ） was much lower than single drug group （ 47. 1%, P 〈 0. 05 ）. Otherwise, after therapy the platelet count in both two groups increased continuously, and at the same time point, the platelet count in anti-helicobacterium pylori group was higher than that in the single drug group （ P 〈 0.05 ）. It is concluded that the ITP children have a higher infection rate of HP, which may be involved in the pathogenesis of ITP. Anti-helicobacterium pylori therapy would help to improve the therapeutic efficacy and reduce the recurrence of ITP children.

关 键 词：血小板减少性紫癜 幽门螺杆菌 儿童 

分 类 号：R554.6[医药卫生—血液循环系统疾病]