根除幽门螺杆菌疗法治疗过敏性紫癜患儿的预后分析

Prognostic analysis of children with Henoch-Schonlein purpura treated by Helicobacter pylori eradication therapy

摘要:

目的 分析根除幽门螺杆菌（Hp）治疗对过敏性紫癜（HSP）患儿预后的影响。方法 153 例HSP 患儿分为Hp 感染治疗组（22 例），在常规治疗基础上加用1 周“三联”根除Hp 方案治疗；Hp 感染对照组（21例）及Hp 感染阴性组（110 例），均给予常规治疗。随访3 组患儿预后情况。结果 治疗组有效率为86%（19/22），对照组有效率为90%（19/21），阴性组有效率为85%（94/110），3 组患儿有效率比较差异无统计学意义（P>0.05）。治疗组HSP 复发率为14%（3/22），对照组复发率为24%（5/21），阴性组复发率为31%（34/110），3 组患儿复发率比较差异亦无统计学意义（P>0.05）。阴性组（36%，40/110）和对照组患儿（33%，7/21）紫癜性肾炎（HSPN）发生率均明显高于治疗组（5%，1/22）（均P<0.05），而对照组与阴性组间HSPN 发生率比较差异无统计学意义（P>0.05）。结论 对Hp 感染的HSP 患儿予1 周“三联”根除Hp 方案治疗，可能有助于降低HSPN 的发生率。

Abstract:

Objective To investigate the effect of Helicobacter pylori (Hp) eradication therapy on prognosis in children with Henoch-Schonlein purpura (HSP). Methods A total of 153 children with HSP were divided into Hp infection treatment group (n=22), Hp infection control group (n=21), and Hp infection-negative group (n=110). The Hp infection treatment group received one-week triple therapy for Hp eradication in addition to conventional treatment, while the Hp infection control group and Hp infection-negative group received conventional treatment. All patients were followed up for prognostic evaluation. Results The response rates of the Hp infection treatment, control, and negative groups were 86% (19/22), 90% (19/21) and 85% (94/110), respectively (P>0.05). The recurrence rates of HSP in the Hp infection treatment, control, and negative groups were 14% (3/22), 24% (5/21) and 31% (34/110), respectively (P>0.05). The incidence of Henoch-Schonlein purpura nephritis (HSPN) in the Hp infection-negative group (36%, 40/110) and control group (33%, 7/21) was significantly higher than that in the Hp infection treatment group (5%, 1/22) (P<0.05 for both), but no significant difference in the incidence of HSPN was found between the control and negative groups (P>0.05). Conclusions One-week triple therapy for Hp eradication may be useful to reduce the incidence of HSPN in children with HSP infected with Hp.