Jackson Shannon C, Beck Paul, Buret Andre G, O'Connor Pamela M, Meddings Jonathan, Pineo Graham, Poon Man-Chiu
Division of Hematology, Department of Medicine, Foothills Medical Centre, 1403-29th Street N·W., Calgary, AB, T2N 2T9, Canada.
Division of Gastroenterology, University of Calgary, Calgary, AB, Canada.
Int J Hematol. 2008 Sep;88(2):212-218. doi: 10.1007/s12185-008-0138-8. Epub 2008 Aug 1.
This prospective Canadian pilot study assesses the platelet response rate in H. pylori positive and negative patients and evaluates potential mechanisms to explain response. Patients with ITP received H. pylori eradication therapy and platelet counts at day 56 were used to assess response. Gastric permeability, stool H. pylori antigen and serum CagA anti-body were done at baseline and at day 60. Twenty-two patients were enrolled with an overall response rate of 27% (6/22). The prevalence of H. pylori was 18% (4/22). Seventy-five percent of the H. pylori positive patients (3/4) achieved a response compared to 17% (3/18) of the H. pylori negative patients (P < 0.05). Seventy-five percent of complete responders have demonstrated long-term ongoing responses at 48 months of follow-up. A trend towards lower post-eradication gastric permeability in responders was seen. Although the prevalence of H. pylori is low, H. pylori positive Canadian patients with ITP may benefit from a trial of H. pylori eradication therapy as a safe and effective means to achieve long term platelet response.
这项前瞻性加拿大试点研究评估了幽门螺杆菌阳性和阴性患者的血小板反应率，并评估了解释反应的潜在机制。患有免疫性血小板减少症（ITP）的患者接受了幽门螺杆菌根除治疗，并在第56天的血小板计数用于评估反应。在基线和第60天检测胃通透性、粪便幽门螺杆菌抗原和血清CagA抗体。共纳入22例患者，总反应率为27%（6/22）。幽门螺杆菌感染率为18%（4/22）。幽门螺杆菌阳性患者中有75%（3/4）出现反应，而幽门螺杆菌阴性患者中这一比例为17%（3/18）（P<0.05）。75%的完全缓解者在48个月的随访中表现出长期持续反应。观察到反应者根除幽门螺杆菌后胃通透性有降低趋势。尽管幽门螺杆菌感染率较低，但加拿大幽门螺杆菌阳性的ITP患者可能从幽门螺杆菌根除治疗试验中获益，这是实现长期血小板反应的一种安全有效的方法。
