儿童新诊断免疫性血小板减少症与幽门螺杆菌感染的相关性研究

程衍杨, 熊昊, 徐之良, 李建新, 李晖, 蔡玮, 韩杰, 李姣姣, 郭琳

中国当代儿科杂志 ›› 2015, Vol. 17 ›› Issue (1) : 22-25.

PDF(1223 KB)
HTML
PDF(1223 KB)
HTML
中国当代儿科杂志 ›› 2015, Vol. 17 ›› Issue (1) : 22-25. DOI: 10.7499/j.issn.1008-8830.2015.01.005
论著·临床研究

儿童新诊断免疫性血小板减少症与幽门螺杆菌感染的相关性研究

  • 程衍杨1, 熊昊2, 徐之良1, 李建新2, 李晖2, 蔡玮2, 韩杰2, 李姣姣3, 郭琳2
作者信息 +

Association between Helicobacter pylori infection and newly diagnosed childhood immune thrombocytopenia

  • CHENG Yan-Yang1, XIONG Hao2, XU Zhi-Liang1, LI Jian-Xin2, LI Hui2, CAI Wei2, HAN Jie2, LI Jiao-Jiao3, GUO Lin2
Author information +
文章历史 +

摘要

目的 明确幽门螺杆菌(H.pylori)感染对儿童新诊断免疫性血小板减少症(ITP)的影响.方法 选取2011 年1 月至2013 年12 月间首次住院并新诊断为ITP 的495 例患儿为病例组;随机选取无血小板减少及其他血液系统疾病的普通呼吸道感染住院患儿123 例作为对照组.依据年龄将两组患儿分为<1 岁组(n=219)、1 岁~ 组(n=161)、3 岁~ 组(n=76)和7~14 岁组(n=39).回顾性分析各年龄段患儿H.pylori感染率,以及H.pylori 感染阳性及阴性ITP 患儿经过相同治疗后的预后情况.结果 病例组中H.pylori 感染率随着ITP 患儿年龄的增长而增加,与对照组各年龄段H.pylori 感染率比较差异均无统计学意义(均P>0.05).H.pylori 感染阳性ITP 患儿均未接受针对H.pylori 的相关治疗,而针对血小板减少经丙种球蛋白和/或激素治疗后缓解率随着年龄的增长而呈现逐渐下降趋势,与各年龄段H.pylori 阴性的ITP 患儿治疗后缓解率比较差异均无统计学意义(均P>0.05).结论 H.pylori 感染可能不是ITP 患儿发病的一个主要致病因素;是否治疗H.pylori并不影响儿童急性ITP 的治疗效果.

Abstract

Objective To study the role of Helicobacter pylori (H. pylori) infection in newly diagnosed childhood immune thrombocytopenia (ITP). Methods A total of 495 children with newly diagnosed ITP who were hospitalized for the first time between January 2011 and December 2013 were included as the case group. A total of 123 children with common respiratory tract infection (not ITP or other diseases of blood system) were randomly selected as the control group. All patients were divided into four groups by age: <1 year group, 1-3 years group, 3-7 years group, and 7-14 years group. The incidence of H. pylori infection in all age groups and the clinical outcomes of ITP children with or without H. pylori infection were retrospectively analyzed. Results The incidence rate of H. pylori infection in the case group increased with increasing age. There was no significant difference in the incidence rate of H. pylori infection between the case and the control groups among subjects of the same age (P>0.05). All the ITP patients were not given anti-H. pylori treatment and only received the treatment (glucocorticoid and/or immunoglobulin) for ITP, and their remission rate declined with increasing age. There was no significant difference in the remission rate between the ITP children with H. pylori infection and those without H. pylori infection in the same age group (P>0.05). Conclusions H. pylori infection may not be a major cause of ITP in children, and the clinical outcomes of children with acute ITP are not affected by receiving anti-H. pylori treatment or not.

关键词

免疫性血小板减少症 / 幽门螺杆菌 / 儿童

Key words

Immune thrombocytopenia / Helicobacter pylori / Child

引用本文

导出引用
程衍杨, 熊昊, 徐之良, 李建新, 李晖, 蔡玮, 韩杰, 李姣姣, 郭琳. 儿童新诊断免疫性血小板减少症与幽门螺杆菌感染的相关性研究[J]. 中国当代儿科杂志. 2015, 17(1): 22-25 https://doi.org/10.7499/j.issn.1008-8830.2015.01.005
CHENG Yan-Yang, XIONG Hao, XU Zhi-Liang, LI Jian-Xin, LI Hui, CAI Wei, HAN Jie, LI Jiao-Jiao, GUO Lin. Association between Helicobacter pylori infection and newly diagnosed childhood immune thrombocytopenia[J]. Chinese Journal of Contemporary Pediatrics. 2015, 17(1): 22-25 https://doi.org/10.7499/j.issn.1008-8830.2015.01.005

参考文献

[1] Graham DY, Kimura K, Shimoyama T, et al. Helicobacter pylori infection in Japan: current status and future options[J]. Eur J Gastroenterol Hepatol, 1994, 6 Suppl 1: S1-S4.
[2] Scandellari R, Allemand E, Vettore S, et al. Platelet response to Helicobacter pylori eradication therapy in adult chronic idiopathic thrombocytopenic purpura seems to be related to the presence of anticytotoxin-associated gene A antibodies[J]. Blood Coagul Fibrinolysis, 2009, 20(2): 108-113.
[3] 潘登, 李艳, 徐海萍, 等. 成人特发性血小板减少性紫癜与 幽门螺杆菌感染的相关性研究[J]. 中国医科大学学报, 2007, 36(1): 96-97.
[4] Michel M, Cooper N, Jean C, et al. Does Helicobater pylori initiate or perpetuate immune thrombocytopenic purpura? [J]. Blood, 2004, 103(3): 890-896.
[5] Morimoto N, Takeuchi H, Takahashi T, et al. Helicobacter pylori associated chronic thrombocytopenic purpura and low molecular weight H.pylori proteins[J]. Scand J Infect Dis, 2007, 39(5): 409-416.
[6] Inaba T, MizunoM, Take S, et al. Eradication of Helicobacter pylori increases platelet count with Immunotic thrombocytopenia in Japan[J]. Eur J Clin Invest, 2005, 35(3): 214-219.
[7] Ferrara M, Capozzi L, Rosso R. Effect of Helicobacter pylori eradication on platelet count in children with Immunotic thrombocytopenia[J]. Hematology, 2009, 14(5): 282-285.
[8] Malfertheiner P, Megraud F, òMorain C, et al. Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report[J]. Gut, 2007, 56(6): 772-781.
[9] 贾万英, 乔丽津. 儿童免疫性血小板减少症与幽门螺杆菌感 染[J]. 中国小儿血液与肿瘤杂志, 2012, 17(6): 283-284, 288.
[10] 韩洁, 武国霞, 蒙长虹, 等. 儿童特发性血小板减少性紫癜 与幽门螺杆菌感染[J]. 四川医学, 2010, 31(1): 65-66.
[11] 中华医学会儿科学分会血液学组,《中华儿科杂志》编辑委 员会. 儿童原发性免疫性血小板减少症诊疗建议[J]. 中华儿 科杂志, 2013, 51(5): 382-384.
[12] 胡群. "儿童原发性免疫性血小板减少症诊疗建议"解读[J]. 中华儿科杂志, 2013, 51(5): 389-391.
[13] 卢新天. 儿童ITP的诊断治疗--国际ITP共识与指南解读[C]. 2011 年全国小儿血液与肿瘤学术会议论文集, 2011: 52-54.
[14] Neunert C, Lim W, Crowther M, et al. The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia[J]. Blood, 2011, 117(16): 4190-4207.
[15] 侯明. 成人特发性血小板减少性紫癜诊断治疗专家共识[J]. 中华血液学杂志, 2009, 30(9): 647-648.
[16] 张运玲, 朱朝敏. 儿童幽门螺杆菌感染的诊断与治疗[J]. 实 用儿科临床杂志, 2012, 27(19): 1541-1544.
[17] 田淑梅, 张淑静, 韩爽. 生物微矩阵(芯片) 方法检测100 例 幽门螺杆菌抗体的临床分析[J]. 中国医学创新, 2011, 8(17): 102-103.
[18] 叶国钦. 儿童幽门螺杆菌感染的新思考[J]. 中国当代儿科杂 志, 2014, 16(3): 248-254.
[19] 舒小莉, 程海英, 杨玲蓉, 等. 蛋白芯片技术在儿童幽门螺 杆菌感染诊断中的应用[J]. 中国当代儿科杂志, 2011, 13(9): 728-731.
[20] Gasbarrini A, Franceschi F, Tartaglione R, et al. Regression of autoimmune thrombocytopenia after eradication of Helicobacter pylori[J]. Lancet, 1998, 352(9131): 878.
[21] 王庆, 苏国宏, 沈杰, 等. 抗幽门螺杆菌在治疗特发性血小 板减少性紫癜中的临床研究[J]. 国际输血及血液学杂志, 2011, 34(6): 489-490.
[22] 张梦, 周翾, 马静瑶, 等. 幽门螺杆菌感染与儿童免疫性血 小板减少症相关性研究[J]. 中华实用儿科临床杂志, 2014, 29(7): 523-526.
[23] 宋丽丽, 白松婷, 邹湘, 等. 幽门螺杆菌在儿童特发性血小 板减少性紫癜的感染状况分析[J]. 中国小儿血液与肿瘤杂 志, 2009, 14(5): 208-210.
[24] 卢洁, 王春美, 许松涛, 等. 幽门螺杆菌感染与儿童急性特 发性血小板减少性紫癜发病及转归的关系[J]. 中华血液学杂 志, 2013, 34(1): 41-44.
[25] Treutiger I, Rajantie J, Zeller B, et al. Does treatment of newly diagnosed idiopathic thrombocytopenic purpura reduce morbidity?[J]. Arch Dis Child, 2007, 92(8): 704-707.
[26] Treepongkaruna S, Sirachainan N, Kanjaaponkul S, et al. Absence of platelet recovery following Helicobacter pylori eradication in childhood chronic idiopathic thrombocytopenic purpura:a multi-center randomized controlled trail[J]. Pediatr Blood Cancer, 2009, 53(1): 72-77.
[27] Loffredo G, Marzano MG, Migloorati R, et al. The relationship between immune thrombocytopenic purpura and Helicobacter pylori infection in children: where is the truth? [J]. Eur J Pediatr, 2007, 166(10): 1067-1068.
[28] Yetgin S, Demir H, Arslan D, et al. Autoimmune thrombocytopenic purpura and Helicobacter pylori infection effectivity during childhood[J]. Am J Hematol, 2005, 78(4): 318.
[29] Neefjes VM, Heijboer H, Tamminga RY, et al. H.pylori infection in childhood chronic immune thrombocytopenic purpura[J]. Haematologica, 2007, 92(4): 576.

PDF(1223 KB)
HTML

Accesses

Citation

Detail

段落导航
相关文章

/