Development of corpus atrophic gastritis may be associated with Helicobacter pylori-related idiopathic thrombocytopenic purpura
Development of corpus atrophic gastritis may be associated with Helicobacter pylori-related idiopathic thrombocytopenic purpura
复制标题
胃体萎缩性胃炎的发生可能与幽门螺杆菌相关的特发性血小板减少性紫癜有关
DOI：
10.1007/s00535-011-0416-8
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发表时间：
2011
影响因子：
6.3
通讯作者：
Fujioka T
中科院分区：
文献类型：
--
作者：
Sato R;Murakami K;Okimoto T;Watanabe K;Kodama M;Fujioka T
背景在慢性特发性血小板减少性紫癜（ITP）患者中，幽门螺杆菌根除与血小板计数增加之间存在严格的相关性。阐明H.幽门螺杆菌诱导的ITP和预测血小板对H. pylori根除治疗，我们评估了ITP patients.MethodsThe研究人口包括31 H萎缩性胃炎的标志物。幽门螺杆菌感染的慢性ITP患者。所有患者在接受上消化道内镜检查和胃活检后，均接受H。幽门根除疗法H.在治疗后6-54个月评价幽门螺杆菌根除对血小板计数的影响。比较血小板治疗有效者和无效者的内镜胃萎缩程度、胃粘膜组织学参数和血清胃蛋白酶原（PG）水平。所有患者的幽门螺杆菌均被成功根除，其中18例（58%）患者出现血小板反应。治疗前应答者的血清胃蛋白酶原（PG）I/II比值显著低于无应答者。应答者的内镜胃萎缩程度显著高于无应答者。此外，活动，炎症和萎缩的胃体，但不是在胃窦的组织学参数的水平，显着更严重的反应者比无反应者，。ConclusionThe发展的胃体萎缩性胃炎可能是一个合适的条件诱导血小板减少症。评估血清、内镜和组织学萎缩性胃炎标志物可能有助于选择更可能对H有反应的ITP患者。幽门根除疗法
BackgroundA strict correlation betweenHelicobacter pylorieradication and an increase in platelet count has previously been reported in patients with chronic idiopathic thrombocytopenic purpura (ITP). To clarify the pathogenesis ofH. pylori-induced ITP and the factors predicting the platelet response toH. pylorieradication therapy, we evaluated the markers of atrophic gastritis in ITP patients.MethodsThe study population comprised 31H. pylori-infected patients with chronic ITP. After undergoing upper gastrointestinal endoscopy and gastric biopsy, all patients receivedH. pylorieradication therapy. The effect ofH. pylorieradication on the platelet count was evaluated for up to 6–54 months after the therapy. The degree of endoscopic gastric atrophy, histological parameters in the gastric mucosa, and serum pepsinogen (PG) levels were compared between platelet responders and nonresponders to the therapy.ResultsH. pyloriwas successfully eradicated in all patients and a platelet response was seen in 18 (58%) of these patients. The serum pepsinogen (PG) I/II ratio at pretreatment was significantly lower in responders than in nonresponders. The degree of endoscopic gastric atrophy was significantly more severe in responders than in nonresponders. Furthermore, the levels of histological parameters of activity, inflammation, and atrophy in the gastric corpus, but not in the gastric antrum, were significantly more severe in responders than in nonresponders,.ConclusionThe development of corpus atrophic gastritis may be a suitable condition for inducing thrombocytopenia. Evaluation of the serum, endoscopic, and histological markers of atrophic gastritis may assist in selecting patients with ITP who are more likely to respond toH. pylorieradication therapy.