免疫性血小板减少性紫癜合并幽门螺杆菌感染患儿免疫功能变化及治疗效果

摘要

目的：分析免疫性血小板减少性紫癜合并幽门螺杆菌感染患者免疫功能的变化及治疗效果。方法选取某院2011年3月-2012年3月收治的80例血小板减少性紫癜患儿作为观察组，根据患儿是否感染幽门螺杆菌，分为感染亚组和未感染亚组；同时，选择同期80例健康儿童作为对照组，比较各组间淋巴细胞亚群测定结果、临床疗效以及复发率。结果观察组幽门螺杆菌阳性率为55．00％（44/80），显著高于对照组的2．50％（2/80），差异有统计学意义（χ2＝12．48，P＝0．008）。各组间CD4＋、CD4＋/CD8＋以及CD19＋T淋巴细胞比较，差异有统计学意义（均P＜0．05）；其中感染亚组患儿CD4＋[（13．40±4．65）％]、CD4＋/CD8＋T淋巴细胞[（0．69±0．18）％]明显低于未感染亚组[分别为（28．56±3．82）％、（1．04±0．23）％]，而CD19＋T淋巴细胞[（45．21±10．20）％]则明显高于未感染亚组[（22．05±2．23）％]；未感染亚组和感染亚组患儿CD4＋、CD4＋/CD8＋T淋巴细胞明显低于对照组[分别为（40．20±3．42）％、（1．54±0．42）％]，而CD19＋T淋巴细胞明显高于对照组[（11．02±2．89）％]。感染亚组和未感染亚组患儿治疗有效率分别为90．91％、91．67％，两组差异无统计学意义（P＞0．05）。感染亚组患儿经抗幽门螺杆菌感染治疗后血小板减少性紫癜复发率（20．45％）显著低于未感染亚组患儿（30．56％；χ2＝6．396，P＝0．038）。结论通过免疫功能检测，有助于临床诊断免疫性血小板减少性紫癜合并幽门螺杆菌的感染。%Objective To analyze the change in immune function and therapeutic effectiveness of children with im-mune thrombocytopenic purpura and Helicobacter pylori(H. pylori)infection. Methods Eighty hospitalized chil-dren with thrombocytopenic purpura between March 2011 and March 2012 were as observation group,and then sub-divided into infected group and non-infected group according to whether they were infected with H. pylori;80 healthy children were as control group . Lymphocyte subsets ,clinical therapeutic effectiveness and recurrence rate among three groups were compared. Results The positive rate of H. pylori in observation group was significantly higher than control group(55.00% [44/80]vs 2.50% [2/80];χ2= 12.48,P= 0.008). There was significant differences in CD4+,CD4+/CD8+ ,and CD19+T lymphocyte among three groups (all P<0.05);CD4+ and CD4+/CD8+ T lymphocyte in infected group was significantly lower than non-infected group respectively ([13.40±4.65]% )vs [28.56± 3.82]% ;[0.69±0.18]% vs [1.04±0.23]% ),and CD19+T lymphocyte in infected group was significantly higher than non-infected group ([45.21±10.20]% vs [22.05±2.23]% );CD4+ and CD4+/CD8+T lymphocyte in non-in-fected group and infected group was significantly lower than control group ([40.20±3.42]% ,[1.54±0.42]% respec-tively),and CD19+T lymphocyte was significantly higher than control group ([11.02±2.89]% ). The overall therapeu-tic effectiveness in infected group and non-infected group was 90.91% and 91.67% respectively(P>0.05). The recur-rence rate of thrombocytopenic purpura after anti-H.pylori infection therapy in infected group was significantly lower than non-infected group (20.45% vs 30.56% ;χ2= 6.396,P= 0.038). Conclusion Detection of immune function is helpful for clinical diagnosis of H. pylori infection associated with immune thrombocytopenic purpura .