Helicobacter pylori and mean platelet volume: a relation way before immune thrombocytopenia?
Abstract
OBJECTIVE:
Helicobacter pylori is associated with chronic immune thrombocytopenia. Eradication of H. pylori has been related with a platelet response and this treatment has been included within management strategies for a certain group of patients. However, in patients with normal platelet counts, the effects of H. pylori infection on platelet count and mean platelet volume as an important platelet index have not been investigated. In this study, we aimed to assess the relation between platelet indices and H. pylori infection in patients with dyspepsia who have otherwise normal platelet counts.
PATIENTS AND METHODS:
In a retrospective manner, 4823 patients with dyspeptic complaints who have underwent an upper gastrointestinal endoscopy and a rapid urease test were included. Data of whole blood counts before the procedure were recorded from their files. Patients with normal endoscopic findings or simple gastritis were included. Patients with malignancy, GI bleeding, portal hypertension, liver or kidney disease and taking nonsteroidal anti-inflammatory drugs, proton pump inhibitors, cytotoxic medications were excluded.
RESULTS:
Mean platelet count in H. pylori positive and negative patients were 246381± 92225/mm3 and 258135 ± 89912/mm3, respectively (p<0.001). Mean MPV was higher in H. pylori positive group (8.9± 1.3 vs. 8.23 ± 0.94, p<0.001). This difference was observed in both genders. MPV was observed to be higher than 10 fL in 20.5% of HP positive patients while in only 2.8% of H. pylori negative patients (p<0.0001).
CONCLUSIONS:
In patients with H. pylori infection and normal platelet counts, it may be speculated that an ongoing and compensated platelet destruction-production process may be responsible for the increase in MPV. Likewise, in conditions exclusive for the host or the H. pylori strain, platelet destruction may be enhanced leading to immune thrombocytopenia. As our study is the first study to investigate the effect of H. pylori in patients with normal platelet counts, our findings may give way to further prospective researches.
摘要
目的：
幽门螺杆菌与慢性免疫性血小板减少相关。幽门螺杆菌的根除已经与血小板的应答相关，该治疗已经被纳入一组患者的管理策略中。但是，在血小板计数正常的患者中，幽门螺杆菌感染对作为一个重要的血小板指标的血小板计数和血小板平均体积的影响尚未被研究。在本研究中，我们旨在评估血小板计数正常的消化不良患者血小板指标与幽门螺杆菌感染的相关性。
患者和方法：
以回顾性研究的方式。共计4832名进行上胃肠道内镜检查和快速尿素酶试验的消化不良被纳入。记录来自他们的档案的操作之前的全血细胞计数的数据。内镜检查正常或简单的胃炎的患者被纳入。恶性肿瘤、GI出血、门脉高压、肝脏或肾脏疾病以及正在服用非甾体消炎药、质子泵抑制剂、细胞毒性药物的患者被排除。
结果：
幽门螺杆菌阳性和阴性患者的平均血小板计数分别为246381± 92225/mm3和258135 ± 89912/mm3（p＜0.001）。在幽门螺杆菌阳性组的平均MPV较高（8.9± 1.3 vs. 8.23 ± 0.94, p<0.001）。在两个性别均观察到该差异。在HP阳性患者的MPV观察到MPV高于10fl，而在HP阴性组仅2.8%（p<0.0001）。
结论：
在幽门螺杆菌感染和血小板计数正常的患者中，可以推测，正在进行的和代偿性的血小板破坏-生成过程可能导致MPV升高。同样地，宿主或幽门螺杆菌菌株独有的情况中，血小板的破坏可能增强并导致免疫性血小板减少。因我们的研究是第一项研究血小板计数正常患者中幽门螺杆菌的影响，我们的结果可能为进一步的前瞻性研究提供方向。
来源：Eur Rev Med Pharmacol Sci. 2015 Aug;19(15):2818-2823. Umit H, Umit EG.
http://www.ncbi.nlm.nih.gov/pubmed/26241535