Helicobacter pylori Infection and Childhood Idiopathic Thrombocytopenic Purpura

背景：近來有研究顯示一部份慢性血小板低下性紫斑症的病人，在幽門螺旋桿菌被根除後，其血小板數目可以恢復正常。因此認爲這些患者之所以會持續性的血小板低下，原因乃在於幽門螺旋桿菌沒有被清除。所以我們就來探討兒童特發性血小板低下性紫斑症發生時，幽門螺旋桿菌感染的情形。同時也探討幽門螺旋桿菌的感染是否會影響其病程的進展。方怯：從2004年9月至2006年6月，我們共收集了32位血小板低下性紫斑症的病童作爲實驗組，同時我們隨機選取了在這段期間某一個月因爲咽喉炎、氣管炎及支氣管肺炎住院的30位病童作爲對照組。我們檢查兩組病患糞便中的幽門螺旋桿菌抗原，統整後被加以分析。結果：我們檢查糞便中的幽門螺旋桿菌抗原來比較患童與同年齡孩童的幽門螺旋桿菌的感染狀態，發現兩組並無差異。我們也探討幽門螺旋桿菌有無感染是否影響對治療的反應，亦無統計學上之差異。雖然幽門螺旋桿菌感染者似乎較易成爲慢性患者，但亦不具統討一意義。結論：儘管幽門螺旋桿菌的感染對兒童特發性血小板低下性紫斑症的發展在本研究中不佔主要角色，但仍有其臨床重要性，進一步的大規模研究是必需的。

關鍵字

兒童；幽門螺旋桿茵；特發性血小板低下性紫斑症

並列摘要

Background: Several studies showed some chronic idiopathic thrombocytopenic purpura (ITP) patients with complete platelet recovery after Helicobacter pylori (H. pylori) eradication and cited the cause of persistent thrombocytopenia as inability to eradicate H. pylori. So we studied H. pylori infection status in pediatric ITP patients at diagnosis and address whether such infection played a role in the development of childhood ITP. Methods: We compared H. pylori infection status by stool H. pylori antigen test of an ITP group including 32 childhood ITP patients at diagnosis from September 2004 to June 2006 and a control group including 30 unselected patients with no history of thrombocytopenia seen consecutively with clinical manifestations of pharyngotonsillitis, bronchitis, or bronchopneumonia in our ward during a one-month span. We further analyzed parameters between H. pylori infection-positive (H. pylori(superscript +)) and H. pylori infection-negative (H. pylori(superscript -)) childhood ITP patients. Results: The H. pylori-positive (H. pylori(superscript +)) rate was 19% in the study group and 17% in the control group, with not statistically significant difference. As for the characteristics and treatment response about H. pylori status, they were also not statistically different. Although the ratio of chronic ITP cases showed higher tendency in H. pylori(superscript +) patients (2/6) than the H. pylori(superscript -) ones (3/26), it was not statistically significant. Conclusions: It seems that H. pylori infection played a minor role in the development of childhood ITP in this small-scale study. A large-scale study is necessary to further confirm the relationship between H. pylori infection and the development of childhood ITP.

並列關鍵字

childhood ； Helicobacter pylori ； idiopathic thrombocytopenic purpura

國際替代計量

Helicobacter pylori Infection and Childhood Idiopathic Thrombocytopenic Purpura

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