Yadav Mukesh K, Rishi Jai P, Nijawan S
Department of Medicine, SMS Medical College, Jaipur, India.
Indian J Med Sci. 2008 Apr;62(4):157-62.
Helicobacter pylori (HP) have recently emerged as a novel eliciting factor for chronic urticaria (CU). The possible association between HP and CU has enormous potential, as eradicating HP could cure CU.
We conducted a study to assess the prevalence of HP infection and effect of bacterium eradication on skin lesions in patients of chronic idiopathic urticaria (CIU).
Four hundred sixty patients of CU attending the allergy clinic, SMS hospital, Jaipur during the period February 6, 2004, to February 6, 2006, were screened for possible eliciting factors. Patients with CIU were enrolled and others were excluded.
Sixty-eight patients of CIU and similar number of age and sex matched controls, attending the allergy clinic, SMS Hospital, Jaipur were enrolled in the study. All patients underwent endoscopy with antral biopsy for urease and histopathology to identify HP-associated gastritis. Infected patients were given HP eradication therapy. Eradication of bacterium was confirmed by fecal antigen assay. Subjective response to treatment was judged using chronic urticaria quality-of-life questionnaire (CU-Q 2 oL) while objective response to treatment was judged by need for 'rescue medication' (antihistaminics).
Data were analyzed using Chi square and paired 't' test for their level of significance.
HP associated gastritis was present in 48 (70.58%) patients, out of which 39 (81.25%) patients responded to eradication therapy. Ten (50.00%) patients without HP associated gastritis showed response to symptomatic therapy. Overall 49 (72.05%) patients responded and 19 (27.94%) showed no response. The value of chi2 was 28.571 (P = 0.003), which showed significant association between presence of HP and response to eradication regimen.
The response of HP eradication therapy in infected patients of CIU is significant. HP should be included in diagnostic workup of patients with CIU.
幽门螺杆菌（HP）最近已成为慢性荨麻疹（CU）的一种新的诱发因素。HP与CU之间可能存在的关联具有巨大潜力，因为根除HP可治愈CU。
我们开展了一项研究，以评估慢性特发性荨麻疹（CIU）患者中HP感染的患病率以及根除该细菌对皮肤损害的影响。
在2004年2月6日至2006年2月6日期间，对斋浦尔SMS医院过敏门诊的460例CU患者进行了可能诱发因素的筛查。纳入CIU患者，排除其他患者。
斋浦尔SMS医院过敏门诊的68例CIU患者以及数量相当的年龄和性别匹配的对照组被纳入研究。所有患者均接受内镜检查及胃窦活检，进行尿素酶检测和组织病理学检查以确定HP相关性胃炎。对感染患者给予HP根除治疗。通过粪便抗原检测确认细菌已被根除。使用慢性荨麻疹生活质量问卷（CU-Q 2oL）判断对治疗的主观反应，通过“急救药物”（抗组胺药）的需求判断对治疗的客观反应。
使用卡方检验和配对t检验分析数据的显著性水平。
48例（70.58%）患者存在HP相关性胃炎，其中39例（81.25%）患者对根除治疗有反应。10例（50.00%）无HP相关性胃炎的患者对对症治疗有反应。总体而言，49例（72.05%）患者有反应，19例（27.94%）无反应。卡方值为28.571（P = 0.003），表明HP存在与根除方案反应之间存在显著关联。
CIU感染患者中HP根除治疗的反应显著。CIU患者的诊断检查应包括HP检测。
