Suvajdzić Nada, Stanković Boris, Artiko Vera, Cvejić Tanja, Bulat Vladislava, Bakrac Milena, Colović Milica, Obradović Vladimir, Atkinson Henry Dushan E
Institute of Hematology, Clinical Center of Serbia, Serbia and Montenegro.
Platelets. 2006 Jun;17(4):227-30. doi: 10.1080/09537100500462487.
We prospectively investigated the prevalence of Helicobacter pylori (H. pylori) infection in a cohort of 54 adult Serbian patients with chronic idiopathic thrombocytopenic purpura (ITP), and examined the effects of its eradication on their platelet counts. H. pylori infection was diagnosed in 39/54 (72.2%) patients, using the 14C-urea breath test; and was significantly higher than in the healthy Serbian population (55% P < 0.05). H. pylori-positive patients were significantly older than H. pylori-negative patients (P = 0.006), though there were no significant differences regarding gender, disease duration, mean platelet counts, previous therapies and spleen status between H. pylori-positive and H. pylori-negative patients. Successful eradication was confirmed in 23/30 (77%) treated patients. Stable platelet recovery was registered in 6/23 eradicated patients (26.1%) and maintained for 18 months. Complete and partial remissions were achieved in two and four patients, respectively, including one highly refractory patient. A significant mean platelet recovery was seen 6 months after successful H. pylori eradication in the group of 23 patients (P < 0.05). No platelet recovery was registered in either H. pylori-negative (n = 15), untreated H. pylori-positive patients (n = 9) or H. pylori-positive non-eradicated patients (n = 7). Even though the pathogenetic mechanisms of H. pylori-induced thrombocytopenia remain obscure, the results of this small prospective study support the use of H. pylori eradication as an effective non-immunosuppressive treatment for chronic ITP.
我们前瞻性地调查了54例成年塞尔维亚慢性特发性血小板减少性紫癜（ITP）患者队列中幽门螺杆菌（H. pylori）感染的患病率，并研究了根除该菌对其血小板计数的影响。采用14C-尿素呼气试验诊断出39/54（72.2%）的患者感染了H. pylori；这一比例显著高于健康的塞尔维亚人群（55%，P<0.05）。H. pylori阳性患者的年龄显著大于H. pylori阴性患者（P = 0.006），不过在性别、病程、平均血小板计数、既往治疗情况及脾脏状态方面，H. pylori阳性和阴性患者之间并无显著差异。在30例接受治疗的患者中，23例（77%）成功根除了H. pylori。23例根除患者中有6例（26.1%）血小板稳定恢复，并持续了18个月。分别有2例和4例患者实现了完全缓解和部分缓解，其中包括1例高度难治性患者。在23例成功根除H. pylori的患者组中，根除后6个月血小板平均显著恢复（P<0.05）。H. pylori阴性患者（n = 15）、未治疗的H. pylori阳性患者（n = 9）或H. pylori阳性但未根除的患者（n = 7）均未出现血小板恢复情况。尽管H. pylori诱导血小板减少的发病机制仍不清楚，但这项小型前瞻性研究的结果支持将根除H. pylori作为慢性ITP的一种有效的非免疫抑制治疗方法。
