Gan G G, Norfaizal A L, Bee P C, Chin E F M, Habibah A H, Goh K L
University Malaya, Faculty of Medicine, Department of Medicine, Kuala Lumpur 50603, Malaysia.
Med J Malaysia. 2013 Jun;68(3):231-3.
Helicobacter Pylori has been implicated with a possible link to immune thrombocytopenia purpura (ITP) and studies have shown contradicting results in platelet recovery after eradication of H pylori infection.
To determine the prevalence of H pylori infection in adult ITP patients in Malaysia and to examine the effect of eradication of H pylori infection in these patients.
50 ITP adult patients from haematology clinics were recruited. A 13C urea breath test for H. pylori infection was performed in all patients. Those with H. pylori infection were treated with standard eradication regimen. Platelet counts were monitored regularly after eradication therapy to assess response. Complete response (CR) was defined as the achievement of platelet counts of >150x10(9)/L within 3 months after eradication therapy and partial response (PR) was defined as platelet count above 50x10(9)/L and/or at least doubling the baseline count.
The median age of patients recruited was 50 years. The majority of patients were female (76%). Chinese was the largest ethnic groups (56%) followed by Malays (28%) and Indians (16%). 11 of the 50 patients (22%) were found to have H. pylori infection and all but one had eradication therapy. Overall, some response was observed in 3 patients (30%) with a CR seen in 2 patients and PR in one patient. However, all these patients had a drop in their platelet counts at 6th month follow up.
The prevalence of H. pylori infection is relatively low in our adult ITP patients (22%) and by eradicating the infection did not have any sustained effect in the platelet recovery.
幽门螺杆菌被认为可能与免疫性血小板减少性紫癜（ITP）有关，并且研究表明，根除幽门螺杆菌感染后血小板恢复情况的结果相互矛盾。
确定马来西亚成年ITP患者中幽门螺杆菌感染的患病率，并研究根除幽门螺杆菌感染对这些患者的影响。
招募了50名来自血液科门诊的成年ITP患者。对所有患者进行了13C尿素呼气试验以检测幽门螺杆菌感染。幽门螺杆菌感染患者接受标准根除方案治疗。根除治疗后定期监测血小板计数以评估反应。完全缓解（CR）定义为根除治疗后3个月内血小板计数达到>150×10⁹/L，部分缓解（PR）定义为血小板计数高于50×10⁹/L和/或至少是基线计数的两倍。
招募患者的中位年龄为50岁。大多数患者为女性（76%）。华人是最大的种族群体（56%），其次是马来人（28%）和印度人（16%）。50名患者中有11名（22%）被发现感染幽门螺杆菌，除1名患者外其余均接受了根除治疗。总体而言，3名患者（30%）出现了一些反应，2名患者达到CR，1名患者达到PR。然而，所有这些患者在随访6个月时血小板计数均下降。
在我们的成年ITP患者中，幽门螺杆菌感染的患病率相对较低（22%），并且根除感染对血小板恢复没有任何持续影响。
