Veneri Dino, Franchini Massimo, Gottardi Michele, D'Adda Mariella, Ambrosetti Achille, Krampera Mauro, Zanetti Flavia, Pizzolo Giovanni
Dipartimento di Medicina Clinica e Sperimentale, Divisione di Ematologia, Università di Verona, Italy.
Haematologica. 2002 Nov;87(11):1177-9.
There are data consistent with an association between idiopathic thrombocytopenic purpura (ITP) and Helicobacter pylori (HP) infection. In addition, a significant increase of platelet count following HP eradication has been reported in a proportion of ITP patients. We describe here our experience on the efficacy of anti-HP treatment in ITP patients.
Between December 1998 and May 2001 sixteen adult patients with ITP and documented HP infection were treated with standard antibiotic therapy for HP eradication (amoxicillin and clarithromycin plus pantoprazole combination). Of these patients, 7 had untreated ITP with mild/moderate thrombocytopenia (median platelet count 70x10(9)/L, range 41-91), 5 had relapsed following a previous steroid treatment (median platelet count 39x10(9)/L, range 30-90) and 4 were refractory to steroids (median platelet count 18.5x10(9)/L, range 9-30).
An improvement of platelet count was observed in 11/15 patients (73.3%) who achieved HP eradication. The difference between the mean platelet count SD before and after HP eradication was statistically significant (51.6 28.2x10(9)/L vs. 143.3 131.1x10(9)/L; p=0.01). Complete or partial responses were obtained in 11/16 treated patients (68.7%). This result still persisted after a median follow-up of 11.7 months.
Our data confirm the efficacy of Helicobacter pylori eradication in increasing platelet count in adult ITP patients.
有数据表明特发性血小板减少性紫癜（ITP）与幽门螺杆菌（HP）感染之间存在关联。此外，据报道部分ITP患者在根除HP后血小板计数显著增加。我们在此描述我们对ITP患者抗HP治疗疗效的经验。
1998年12月至2001年5月期间，16例确诊为ITP且有HP感染的成年患者接受了根除HP的标准抗生素治疗（阿莫西林、克拉霉素加泮托拉唑联合用药）。这些患者中，7例为未经治疗的轻度/中度血小板减少的ITP患者（血小板计数中位数为70×10⁹/L，范围41 - 91），5例曾接受过类固醇治疗后复发（血小板计数中位数为39×10⁹/L，范围30 - 90），4例对类固醇治疗无效（血小板计数中位数为18.5×10⁹/L，范围9 - 30）。
15例根除HP的患者中有11例（73.3%）血小板计数有所改善。根除HP前后平均血小板计数标准差的差异具有统计学意义（51.6±28.2×10⁹/L对143.3±131.1×10⁹/L；p = 0.01）。16例接受治疗的患者中有11例（68.7%）获得了完全或部分缓解。中位随访11.7个月后，这一结果仍然存在。
我们的数据证实了根除幽门螺杆菌对提高成年ITP患者血小板计数的疗效。
