Noonavath Ravinder Naik, Lakshmi Chandrasekharan Padma, Dutta Tarun Kumar, Kate Vikram
Ravinder Naik Noonavath, Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India.
World J Gastroenterol. 2014 Jun 14;20(22):6918-23. doi: 10.3748/wjg.v20.i22.6918.
To assess the effect of Helicobacter pylori (H. pylori) eradication on platelet counts in patients with chronic immune thrombocytopenic purpura (cITP).
A total of 36 cITP patients were included in the study. The diagnosis of H. pylori was done by rapid urease test and Giemsa staining of the gastric biopsy specimen. All H. pylori positive patients received standard triple therapy for 14 d and were subjected for repeat endoscopy at 6 wk. Patients who continued to be positive for H. pylori on second endoscopy received second line salvage therapy. All the patients were assessed for platelet response at 6 wk, 3(rd) and 6(th) months.
Of the 36 patients, 17 were positive for H. pylori infection and eradication was achieved in 16 patients. The mean baseline platelet count in the eradicated patients was 88615.38 ± 30117.93/mm(3) and platelet count after eradication at 6 wk, 3 mo and 6 mo was 143230.77 ± 52437.51/mm(3) (P = 0.003), 152562.50 ± 52892.3/mm(3) (P = 0.0001), 150187.50 ± 41796.68/mm(3) (P = 0.0001) respectively and in the negative patients, the mean baseline count was 71000.00 ± 33216.46/mm(3) and at 6 wk, 3(rd) and 6(th) month follow up was 137631.58 ± 74364.13/mm(3) (P = 0.001), 125578.95 ± 71472.1/mm(3) (P = 0.005), 77210.53 ± 56892.28/mm(3) (P = 0.684) respectively.
Eradication of H. pylori leads to increase in platelet counts in patients with cITP and can be recommended as a complementary treatment with conventional therapy.
评估根除幽门螺杆菌（H. pylori）对慢性免疫性血小板减少性紫癜（cITP）患者血小板计数的影响。
本研究共纳入36例cITP患者。通过快速尿素酶试验和胃活检标本的吉姆萨染色诊断H. pylori。所有H. pylori阳性患者接受标准三联疗法14天，并在6周时接受重复内镜检查。第二次内镜检查时仍为H. pylori阳性的患者接受二线挽救治疗。所有患者在6周、3个月和6个月时评估血小板反应。
36例患者中，17例H. pylori感染阳性，16例实现根除。根除患者的平均基线血小板计数为88615.38±30117.93/mm³，根除后6周、3个月和6个月时的血小板计数分别为143230.77±52437.51/mm³（P = 0.003）、152562.50±52892.3/mm³（P = 0.0001）、150187.50±41796.68/mm³（P = 0.0001）；阴性患者的平均基线计数为71000.00±33216.46/mm³，6周、3个月和6个月随访时分别为137631.58±74364.13/mm³（P = 0.001）、125578.95±71472.1/mm³（P = 0.005）、77210.53±56892.28/mm³（P = 0.684）。
根除H. pylori可使cITP患者的血小板计数增加，可作为传统治疗的辅助治疗方法推荐。
