【摘要】 目的探讨免疫性血小板减少症(ITP)患儿感染幽门螺杆菌(Hp)的特点及抗感染治疗的意义。方法采用13 C尿素呼气试验检测142例ITP患儿和92例健康儿童Hp感染情况。将ITP患儿中97例阳性者分为两组:联合治疗组49例,应用糖皮质激素联合抗Hp治疗;单药治疗组48例,单用糖皮质激素治疗。分别检测两组治疗前后血小板相关参数、血小板相关抗体和淋巴细胞亚群的变化。结果 ITP患儿Hp的感染率为69.7%,明显高于健康儿童(40.2%)。两组患儿治疗6个月后,联合治疗组患儿血小板计数、PCT、CD3+、CD3+CD4+和CD3+CD4+/CD3+CD8+升高水平明显高于单药治疗组(P<0.01),而MPV、PDW、PAIgG、PAIgA、CD3+CD8+下降水平均高于单药治疗组(P<0.01)。结论 ITP患儿Hp感染率高于健康儿童;Hp可能通过影响机体免疫功能参与了儿童ITP的发病和发展过程,联合抗Hp治疗可改善ITP患儿机体免疫状态,提高治疗效果。更多还原

【Abstract】 Objective To explore the clinic character of immune thrombocytopenia(ITP)children infected with helicobacter pylori(Hp)and the effects of anti-helicobacter pylori treatment on those children.Methods One hundred and forty-two ITP children and 92 healthy children were conducted the 13 C-Urea breath test to determine the infections of Hp.The ITP children infected with Hp were divided into two groups:single drug group(48cases,treated only with corticosteroid)and combined drugs group(49cases,treated with corticosteroid and anti-helicobacter pylori treatment).The platelet parameters,platelet associated immunoglobulin and some lymphocyte subsets were analyzed.Results Ninety seven children infected with Hp were found in 142 ITP children(69.7%).In the mean time,37 children infected with Hp were observed in 92 healthy children(40.2%).After treatment of 6months,the PLT,PCT,CD3+,CD3+CD4+and CD3+CD4+/CD3+CD8+of ITP children in both group were increased,and the increased degree of those parameters were much higher in combined drug group than those in single drug group(P<0.01).However,the MPV,PDW,PAIgG,PAIgA and CD3+CD8+were more decreased than that of the single drug group(P<0.01).Conclusion The ITP children have a higher infection rate of Hp,which may be involved in the pathogenesis of ITP.Anti-helicobacter pylori therapy would improve the therapy efficacy of ITP children infected with Hp by improving their immunity.更多还原