Barbosa Alzira Maria de Castro, Ribeiro Rosangela Albuquerque, Silva Cícero Ígor Simões Moura, Cruz Francisco Will Saraiva, Azevedo Orleancio Gomes Ripardo de, Pitombeira Maria Helena da Silva, Braga Lucia Libanez Campelo
Universidade Federal do Ceará (UFC), Fortaleza, CE, Brazil.
Centro de Hematologia e Hemoterapia do Ceará (Hemoce), Fortaleza, CE, Brazil.
Hematol Transfus Cell Ther. 2018 Jan-Mar;40(1):12-17. doi: 10.1016/j.bjhh.2017.09.005. Epub 2017 Nov 24.
Several studies have demonstrated that platelet counts in Helicobacter pylori-positive patients with chronic idiopathic thrombocytopenic purpura improved significantly after successful eradication of the infection. However, depending of the geographical region of the study the results have been highly divergent.
The purpose of this study was to evaluate the effect of H. pylori eradication therapy on platelet count in a cohort of chronic idiopathic thrombocytopenic purpura patients from northeastern Brazil.
H. pylori status was determined in 28 chronic idiopathic thrombocytopenic purpura patients using the rapid urease test and histology. H. pylori-positive patients received standard triple therapy for one week. The effect of the eradication therapy was evaluated using the 13C-urea breath test two to three months after treatment.
The prevalence of H. pylori infection was similar to that found in the general population. Twenty-two patients (78.5%) were H. pylori-positive. Fifteen were treated, 13 (86%) of whom successfully. At six months, 4/13 (30%) displayed increased platelet counts, which remained throughout follow-up (12 months). Platelet response was not associated to mean baseline platelet count, duration of chronic idiopathic thrombocytopenic purpura, gender, age, previous use of medication, or splenectomy.
H. pylori eradication therapy showed relatively low platelet recovery rates, comparable with previous studies from southeastern Brazil. The effect of H. pylori eradication on platelet counts remained after one year of follow-up suggesting that treating H. pylori infection might be worthwhile in a subset of chronic idiopathic thrombocytopenic purpura patients.
多项研究表明，慢性特发性血小板减少性紫癜的幽门螺杆菌阳性患者在成功根除感染后血小板计数显著改善。然而，根据研究的地理区域不同，结果差异很大。
本研究旨在评估幽门螺杆菌根除治疗对一组来自巴西东北部的慢性特发性血小板减少性紫癜患者血小板计数的影响。
采用快速尿素酶试验和组织学方法对28例慢性特发性血小板减少性紫癜患者进行幽门螺杆菌感染状况检测。幽门螺杆菌阳性患者接受标准三联疗法治疗一周。治疗后两到三个月采用13C-尿素呼气试验评估根除治疗的效果。
幽门螺杆菌感染的患病率与普通人群相似。22例患者（78.5%）幽门螺杆菌阳性。15例接受治疗，其中13例（86%）治疗成功。六个月时，4/13（30%）患者的血小板计数增加，且在整个随访期（12个月）内一直保持升高。血小板反应与平均基线血小板计数、慢性特发性血小板减少性紫癜病程、性别、年龄、既往用药情况或脾切除术无关。
幽门螺杆菌根除治疗显示血小板恢复率相对较低，与巴西东南部此前的研究结果相当。随访一年后，幽门螺杆菌根除对血小板计数的影响依然存在，这表明对一部分慢性特发性血小板减少性紫癜患者进行幽门螺杆菌感染治疗可能是值得的。
