Kong Rong, Qiu Hong-Chun, Wu Peng-Fei, Niu Xue-Hua, Shen Wen-Xiang, Wang Yong
Department of Hematology, Kunshan Third People Hospital, Kunshan 215300, Jiangsu Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2008 Oct;16(5):1222-6.
This study was purposed to investigate the infection incidence of Helicobacter pylori (HP) in patients with idiopathic thrombocytopenic purpura (ITP) and curative efficacy of glucocorticoids combined with anti-helicobacter. 100 ITP patients with positive HP were divided randomly into 3 groups: glucocorticoid group (treatment with glucocorticoids, n = 35), anti-HP treatment group (HP eradication, n = 30) and combined treatment group (glucocorticoid combined with HP eradication, n = 35). 100 healthy individuals were selected as control. The results showed that HP infection rate in ITP group was 70%, while HP infection rate in control group (persons received physical examination) was 56%, there was significant difference between two groups (p < 0.05). The HP of 31 cases in combined treatment group was eradicated that the platelet count in 23 out of 31 cases recovered to normal, and in 8 cases was higher than that before treatment, which mean count was (165 +/- 225) x 10(9)/L, this value had statistical significance as compared with that before treatment (p < 0.01). Total efficiency in this group reached to 89%, and relapse rate within 1 year was 8%. The HP infection of 2 cases in glucocorticoid group had been turned to negative naturally, and platelet count recovered to normal, while HP infection in remained 33 cases was still positive. The platelet count in 23 out of 33 cases of that group was not back to normal, but back to normal in 10 cases. The platelet mean count in that group was (78 +/- 26) x 10(9)/L with total efficiency rate of 68% and relapse rate within 1 year was 37%. In the anti-HP treatment group, HP infection in 25 cases was eradicated and platelet count in 9 out of 25 cases recovered to normal, that platelet count in 9 cases was higher than that before treatment, platelet mean count was (135 +/- 174) x 10(9)/L), there was significant difference (p < 0.01), as compared with value before treatment. Total efficiency rate in this group reached to 60%, and relapse rate within 1 year was 33%. It is concluded that the patients with ITP have higher HP infection incidence, and the eradication of HP is effective therapy for the ITP patients with HP infection, which can be used as initial treatment.
本研究旨在探讨特发性血小板减少性紫癜（ITP）患者幽门螺杆菌（HP）的感染率以及糖皮质激素联合抗幽门螺杆菌治疗的疗效。100例HP阳性的ITP患者随机分为3组：糖皮质激素组（用糖皮质激素治疗，n = 35）、抗HP治疗组（根除HP，n = 30）和联合治疗组（糖皮质激素联合根除HP，n = 35）。选取100例健康个体作为对照。结果显示，ITP组的HP感染率为70%，而对照组（接受体检者）的HP感染率为56%，两组间差异有统计学意义（p < 0.05）。联合治疗组31例患者的HP被根除，其中31例中有23例血小板计数恢复正常，8例高于治疗前，平均计数为（165±225）×10⁹/L，与治疗前相比该值有统计学意义（p < 0.01）。该组总有效率达89%，1年内复发率为8%。糖皮质激素组2例患者的HP感染自然转阴，血小板计数恢复正常，而其余33例患者的HP感染仍为阳性。该组33例中有23例血小板计数未恢复正常，10例恢复正常。该组血小板平均计数为（78±26）×10⁹/L，总有效率为68%，1年内复发率为37%。在抗HP治疗组中，25例患者的HP感染被根除，25例中有9例血小板计数恢复正常，9例血小板计数高于治疗前，血小板平均计数为（135±174）×10⁹/L，与治疗前值相比差异有统计学意义（p < 0.01）。该组总有效率达60%，1年内复发率为33%。结论：ITP患者HP感染率较高，根除HP对HP感染的ITP患者是有效的治疗方法，可作为初始治疗。
