Fujimura Kingo
Department of Pharmacy, Yasuda Women's University.
Nihon Rinsho. 2013 Aug;71(8):1436-41.
In many extragastric manifestations with Helicobacter pylori (HP) infection, the most convincing evidences were observed in idiopathic thrombocytopenic purpura (ITP). The prevalence of HP infection in ITP was not different to general population. The high association of HP infection in ITP was reported in Italy and Japan but low in USA and UK. After eradication therapy, platelet counts response was found in over 50% of ITP cases in Japan and Italy, and about 40% in other countries. The platelet counts response following eradication was maintain for long time with drug free and the relapse case was rare. The platelet elevation reaction by eradication was not influenced by previous treatment, sex and age, but the disease duration as ITP and the platelet count before eradication were controversial factors. The main side effects of eradication were diarrhea, vomiting and skin rash. Based on these evidences, ITP guideline in Japan (2012) recommended that eradication therapy was the first choice treatment for HP positive ITP cases.
在许多幽门螺杆菌（HP）感染的胃外表现中，特发性血小板减少性紫癜（ITP）有最令人信服的证据。ITP中HP感染的患病率与普通人群无异。意大利和日本报道ITP中HP感染的关联度高，而美国和英国则低。根除治疗后，日本和意大利超过50%的ITP病例血小板计数有反应，其他国家约为40%。根除后血小板计数反应在无药物情况下能长期维持，复发病例罕见。根除引起的血小板升高反应不受既往治疗、性别和年龄影响，但作为ITP的病程以及根除前的血小板计数是有争议的因素。根除的主要副作用是腹泻、呕吐和皮疹。基于这些证据，日本（2012年）的ITP指南推荐根除治疗是HP阳性ITP病例的首选治疗方法。
