抗幽门螺杆菌治疗腹型过敏性紫癜临床疗效研究

发布时间：2018-06-14 16:43

本文选题：过敏性紫癜 + 治疗　；参考：《吉林大学》2012年硕士论文

【摘要】：目的：探讨抗幽门螺杆菌（Helicobacter pylori，HP）治疗腹型过敏性紫癜（Henoch-Sch nlein purpura,HSP）的临床疗效。资料与方法：选择2009年10月至2012年1月吉林大学中日联谊医院儿科住院及门诊128例已确诊为过敏性紫癜且均不同程度伴有恶心、呕吐、腹痛、腹泻及便血等胃肠道症状的患儿，采用血幽门螺旋杆菌检测及胃镜取活检组织检测HP法进行HP检测，两项检测结果均呈阳性者为HP感染阳性，结果HP感染阳性者88例。将88例HP阳性的过敏性紫癜患儿完全随机分为两组，治疗组与对照组各44例。对照组患儿给予HSP常规方案治疗，即：抗过敏、激素治疗，若有感染患儿适当给予抗生素治疗。治疗组患儿除常规方案治疗外，加用抗HP三联疗法：奥美拉唑0.8mg/kg d，2次/d，阿莫西林50mg/kg d，3次/d，克拉霉素15mg/kg d，2次/d，疗程2周。2周后根据HSP疗效判断标准分别计算两组患儿治疗有效率，并对其进行随访分别记录两组患儿复发率。最后采用SPSS17.0软件进行对两组数据进行χ2检验，分析比较是否存在统计学差异。结果：全部128例患儿应用血幽门螺旋杆菌检测及胃镜取活检组织检测HP法进行HP检测，两项检测结果均呈阳性者为HP感染阳性，结果HP感染阳性者88例，HP阳性检出率为68.75%；治疗组加入抗HP治疗后有效率为95.5%，对照组有效率为72.2%，两组数据差异具有统计学意义（P0.05）；治疗组抗HP治疗后，胃肠道症状缓解迅速，复发率为9.5%，而对照组为18.9%，两组数据差异具有统计学意义（P0.05）。结论：HP感染与腹型过敏性紫癜相关密切，对于过敏性紫癜患儿，，尤其是合并有胃肠道症状的患儿，应尽早做HP常规检测，对于HP检测阳性者在常规治疗的基础上加入抗HP治疗，可有效提高治疗疗效，尽早控制症状，缩短病程，降低复发率，对改善过敏性紫癜的预后意义重大，应引起临床的高度重视。
[Abstract]:Objective: to investigate the clinical efficacy of Helicobacter pylori (Helicobacter pylori) in the treatment of Henoch-Sch nlein purpura (HSP). Materials and methods: from October 2009 to January 2012, 128 children with gastrointestinal symptoms, including nausea, vomiting, abdominal pain, diarrhoea and hematochezia, were diagnosed as allergic purpura in pediatric and outpatient department of Sino-Japanese Friendship Hospital of Jilin University. HP was detected by blood Helicobacter pylori test and biopsy by gastroscope. The HP infection was positive in both cases and 88 cases were HP positive. 88 cases of HP positive Henoch-Schonlein purpura were randomly divided into two groups, 44 cases in the treatment group and 44 cases in the control group. In the control group, the patients were treated with the routine regimen of HSP, that is, antiallergic, hormone therapy, and antibiotic therapy if there was infection. In the treatment group, in addition to routine treatment, the treatment group was treated with anti-HP triple therapy: omeprazole 0.8mg/kg dan2 / d, amoxicillin 50mg/kg dan3 / d, clarithromycin 15mg/kg dan2 / d. After 2 weeks of treatment, the effective rates of the two groups were calculated according to the criteria for judging the curative effect of HSP2. The recurrence rates of the two groups were recorded by follow-up. Finally, SPSS 17.0 software was used to carry on 蠂 2 test to the two groups of data, and the statistical difference was analyzed and compared. Results: all 128 children were tested for HP by blood helicobacter pylori test and biopsy under gastroscopy. The HP positive rate was found in 88 patients with HP infection, and the HP positive rate was 68.75 in 88 patients with HP infection. The effective rate of anti-HP treatment was 95.5g in the treatment group and 72.2in the control group, and the difference between the two groups was statistically significant (P 0.05). The recurrence rate was 9.5%, while that in the control group was 18.9%. The difference between the two groups was statistically significant (P 0.05). Conclusion the infection of HP is closely related to the abdominal anaphylactoid purpura. Routine detection of HP should be done as soon as possible in children with Henoch-Schonlein purpura, especially in children with gastrointestinal symptoms. For HP positive patients, adding anti-HP therapy on the basis of routine treatment can effectively improve the therapeutic effect, control symptoms as soon as possible, shorten the course of disease and reduce the recurrence rate. It is of great significance to improve the prognosis of Henoch-Schonlein purpura. Clinical attention should be paid to it.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R725.5

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