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免疫性血小板减少性紫癜患者幽门螺旋杆菌的检测及其临床意义

  • 摘要: 目的 分析幽门螺旋杆菌 (HP)在免疫性血小板减少性紫癜 (ITP)患者脾脏中的存在情况及与临床相关性。方法 纳入四川大学华西医院肝胆胰外科42例行腹腔镜脾切除术的ITP患者 (男10例,女32例,平均年龄36.4岁),另纳入10例行外伤性脾破裂行脾切除术的患者 (男8例,女2例,平均年龄36.6岁)作为正常对照组。采用C 14呼气实验检测ITP患者的HP感染情况,对患者手术切除的脾脏标本切片后进行HP免疫组织化学染色及吉姆萨染色,并结合患者临床资料进行分析。结果 42例ITP患者中HP感染者为36例 (85.7%),正常对照组中HP感染者为3 (30%)例;ITP组HP免疫组化阳性为12例,正常对照组HP免疫组化阳性为1例。对ITP患者的脾脏组织切片行吉姆萨染色,部分切片结果为可疑阳性,正常对照组均为阴性。感染HP的ITP患者中,无ITP轻度,中度为4例,重度为7例,极重度为25例。未感染HP的ITP患者中,无轻度患者,中度、重度和极重度分别均为2例。结论 在ITP患者的脾脏组织中证实有病原体HP的存在。HP感染与ITP患病的严重程度相关。

     

    Abstract: 【Abstract】 Objective To observe the efficacy of umbilical cord mesenchymal stem cells (UC-MSCs) transplantation for the patients with refractory systemic lupus erythematosus (SLE). Methods Thirty seven patients with SLE were enrolled in this study, and divided into conventional treatment group (control group, n=20) and UC-MSCS adjuvant treatment group (treatment group, n=17). All the patients in both two groups were treated with glucocorticoids and cyclophosphamide (CTX). In the UC-MSCs group, each patient additionally received the transplantation of 3×107UC-MSCs infusion intravenously. The clinical manifestations and laboratory parameters of each patient were observed before the treatments and 2 weeks, 1 month, 2 months, 3 months, 6 months, 9 months and 12 months after the treatments. Results All the 37 patients were observed for 12 months. 24 h urinary protein excretion (U-Pro), anti nuclear antibody (ANA), erythrocyte sedimentation rate (ESR), high-sensitivity C-reactive protein (hs-CRP), systemic lupus erythematosus disease activity index (SLEDAI) of these two groups decreased significantly (P<0.05). serum albumin (ALB), C3, and C4 of two groups were higher after the treatments (P<0.05). ALB and C3 in treatment group exceeded the control group (P<0.05). The positive rates of Anti-dsDNA in control and treatment group were 40% and 10% respectively, while the recurrence rates were 50% and 20% respectively, these difference between the two groups were statistically significant (P<0.05). There were no transplantation related complications observed. Conclusion UC-MSCs transplantation could be effective and safe for refractory SLE on basis of glucocorticoid and cyclophosphamide therapy.

     

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