Eradication of Helicobacter pylori in children with chronic idiopathic thrombocytopenic purpura Efficacy
|School||Fourth Military Medical University|
|Keywords||Helicobacter pylori Thrombocytopenic Purpura Idiopathic Chronic Child|
Background and Purpose: Helicobacter pylori (Helicobacter pylori, H pylori) is a widely occurring bacteria, humans generally susceptible to global infection rate of about 50%. China is a high prevalence of H pylori countries about 59% of the population is infected, H pylori infection leads to disease on the health of our population poses a great threat. Since 1982, Warren and Marshall reported Helicobacter pylori gastritis, peptic ulcer disease-causing factors, the large number of studies have confirmed that H pylori and gastric cancer, gastric mucosa-associated tissue lymphoma (mucosa-associated lymphoid tissue lymphoma, MALT) related. Recent studies have found that H pylori can cause digestive foreign diseases, such as cardiovascular disease, respiratory diseases and autoimmune diseases. Idiopathic thrombocytopenic purpura (idiopathic thrombocytopenic purpura, ITP) is a common autoimmune bleeding disorder, which occurs mainly because of the presence in the blood of patients antiplatelet autoantibodies (Platelet associated immune globulin PAIgG) causing platelet destruction , there peripheral thrombocytopenia, spontaneous bleeding and other clinical manifestations. Some patients with persistent disease, develop into chronic idiopathic thrombocytopenic purpura (chronic ITP, CITP), the disease long-term immunosuppressive therapy side effects caused tremendous harm to the patient. The past 10 years, Italy and Japan some scholars study found that H pylori infection associated with CITP adult patients, some anti-H pylori therapy cured after treatment platelet count increased significantly, accompanied by reduced levels of serum PAIgG, while anti-H pylori is invalid patients with platelet count and no significant change PAIgG that H pylori infection and causative factor may be one of CITP, anti-H pylori therapy can play a role in improving the CITP. It has been reported that H pylori infection and ITP irrelevant. In this study, H pylori infection and the relationship between children's CITP for the clinical treatment of children CITP find a non-immunosuppressive therapeutic approach. METHODS: From October 2008 to October 2009 CITP systematic observation of 37 cases in children. H pylori antigen in stool by ELISA (H pylori stool test, H pyloriSA) detection of H pylori infection in children, according to H pylori test results into H pylori () and H pylori (-) group. Two groups of children were given Triple H pylori eradication therapy: amoxicillin tablet 50mg / (Kg.d), 3 times / d; clindamycin tablets 15mg / (Kg.d), 3 times / d; Ogilvy omeprazole enteric-coated tablets 0.8mg / (Kg.d), 1 times / d; any history of penicillin allergy, then changed to amoxicillin metronidazole 30mg / (Kg.d), 3 times / d. 2 weeks. Platelet count before treatment was measured line basis, after treatment for 4 weeks after H pyloriSA, H pylori eradication to understand the situation, platelet counts measured every 2 weeks. Follow-up six months. Results: (1) 37 cases of 22 cases of children tested H pylor (i), H pylori infection rate was 59.5%; (2) 22 cases of H pylor (i) by H pylori eradication in children, 17 cases of successful eradication eradication success rate of 77.3%. (3) 11 cases of successful eradication of H pylori in children 8-12 weeks after treatment, the platelet count begins to rise, to reach full effect of which seven cases, four patients achieved partial effect, efficiency 64.7%, platelet count before and after treatment was significantly different (P = 0.001). H pylori (-) patients after treatment, no significant increase in platelet counts before and after treatment showed no significant difference (P = 0.154). H pylori () and H pylori (-) patients platelet count after treatment there was a significant difference (P = 0.006). CONCLUSION: H pylori eradication therapy with H pylori infection on the part of the CITP children can play to enhance the role of platelets, H pylori may be a causative factor for CITP. Clinically, patients should be routinely for CITP line H pylori detection of H pylori-positive patients in a timely manner anti-H pylori treatment in order to achieve little or no immunosuppressive activity, as part of the clinical treatment of patients looking for a non-CITP immunosuppressive therapy Methods.