儿童特发性血小板减少性紫癜合并幽门螺杆菌感染123例分析

doi:10.3877/cma.j.issn.1673-5250.2011.02.007

目的

探讨特发性血小板减少性紫癜(idiopathic thrombocytopenic purpura，ITP)与幽门螺杆菌(Helicobacter pylori，HP)感染的关系及治疗措施。

方法

选取2006年8月至2010年4月在本院血液科经临床及骨髓检查确诊为特发性血小板减少性紫癜患儿123例为研究对象，采用幽门螺杆菌免疫印迹试剂盒检测血清中各幽门螺杆菌抗体及可溶性幽门螺杆菌(soluble-helicobacter pylori，S-HP)抗原。(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准，得到该委员会批准，征得受试对象监护人的知情同意，并与之签署临床研究知情同意书)。

结果

123例特发性血小板减少性紫癜患儿中，50例(40.7%)合并幽门螺杆菌感染。幽门螺杆菌感染抗体类型主要为UreB抗体、VacA抗体和CagA抗体，三者均合并S-HP抗原为主；其中部分特发性血小板减少性紫癜合并幽门螺杆菌感染患儿采用激素联合抗幽门螺杆菌治疗有效。

结论

特发性血小板减少性紫癜发病与幽门螺杆菌感染可能有一定关系。

关键词: 儿童, 特发性血小板减少性紫癜, 幽门螺杆菌感染

Objective

To explore the relationship between idiopathic thrombocytopenic purpura (ITP) and Helicobacter pylori (HP) infection in children.

Methods

From August 2006 to April 2010, a total of 123 children were included into this study, who were diagnosed as idiopathic thrombocytopenic purpura by clinical characters and bow marrow cells examinations. Serum Helicobacter pylori antibodies and soluble-Helicobacter pylori (S-HP) antigen were measured by immune blotting method (Western Blot). The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Kunming Children's Hospital. Informed consent was obtained from all participants.

Results

The results showed 50 (40.7%) cases accompanied with Helicobacter pylori infection among 123 patients with idiopathic thrombocytopenic purpura. The main serum antibody types of Helicobacter pylori infection in 50 Helicobacter pylori-positive patients with idiopathic thrombocytopenic purpura included anti-UreB, anti-VacA, anti-CagA and all with soluble-Helicobacter pylori antigen. The glucocorticoid combined with Helicobacter pylori eradication was effective therapy for the idiopathic thrombocytopenic purpura combined with Helicobacter pylori infection.

Conclusion

The pathogenesis of idiopathic thrombocytopenic purpura may related with Helicobacter pylori infection.

Key words: child, idiopathic thrombocytopenic purpura (ITP), Helicobacter pylori infection

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Analysis of 123 Children of Idiopathic Thrombocytopenic Purpura Combined With Helicobacter Pylori Infection

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Analysis of 123 Children of Idiopathic Thrombocytopenic Purpura Combined With Helicobacter Pylori Infection