幽门螺杆菌在儿童特发性血小板减少性紫癜中的临床意义
概要:
摘要 本研究旨在探讨幽门螺杆菌(helicobacter pylori,HP)在儿童特发性血小板减少性紫癜(ITP)中的临床意义。用13C 尿素呼气试验检测92 例 ITP 儿童患者的感染情况,并检测66 名健康儿童作为对照组。将 ITP 患儿中68例阳性者随机分为 2 组:复合用药治疗组 34 例,应用糖皮质激素 + 抗菌治疗;单药治疗组 34 例,用糖皮质激素治疗。结果表明:ITP 患儿 HP 的感染率为 74.7%,明显高于对照组(39.4%)(P<0.05)。ITP患儿经治疗后,单药治疗组的总有效率(73.5%)明显低于复合用药治疗组的总有效率(94.1%)(P<0.05);治疗组 1 年内的复发率(17.6%)明显低于单药治疗组(47.1%)(P<0.05);治疗过程中患儿外周血血小板计数均呈逐渐上升趋势,在相同时间点,复合用药治疗组血小板计数明显高于单药治疗组(P<0.01)。结论:ITP 患儿 HP 感染率高于健康儿童,HP可能参与了儿童 ITP 的发病过程,抗 HP 治疗可提高 ITP 患儿的治疗效果,降低其复发率。
Abstract This study was aimed to investigate the clinic significance of helicobacter pylori(HP) in children with idiopathic thrombocytopenic purpura(ITP). The infection of HP in 92 ITP children was determined by 13C-Urea Breath Test,the same test was also performed on 66 healthy children. The 68 children infected with HP were randomly divided into 2 groups: single drug group treated only with corticosteroid and; combined drug group treated with corticosteroid and anti-helicobacter pylori treatment. The results showed that 68 patients infected with HP were found in 92 ITP children(74. 7%),26 patients infected with HP were observed in 66 healthy children (39.4%),which was lower than that in ITP children (74.7%, P<0.05). After anti-helicobacter pylori therapy,the total effective rate and cure rate of ITP patients increased respectively from 73.5% to 94.1 %, and the total recurrence rate(17.0%) was much lower than single drug group( 47.1%,P<0.05). Otherwise, after therapy the platelet count in both two groups increased continuously, and at the same time point, the platelet count in anti-helicobacterium pylori group was higher than that in the single drug group(P<0.05). It is concluded that the ITP children have a higher infection rate of HP,which may be involved in the pathogenesis of ITP. Anti-helicobacterium pylori therapy would help to improve the therapeutic efficacy and reduce the recurrence of ITP children.
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