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C14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。 Objective To analyze the presence and clinical relevance of Helicobacter pylori (HP) in the spleen of patients with immune thrombocytopenic purpura (ITP). Methods 42 cases of ITP patients undergoing laparoscopic splenectomy (10 males and 32 females, mean age 36.4 years) were enrolled in the study of hepatobiliary and pancreatic surgery in West China Hospital of Sichuan University. Ten patients with splenectomy underwent traumatic rupture of spleen (8 males and 2 females, average age 36.6 years) as a normal control group. The C14 breath test was used to detect the HP infection of ITP patients. The spleen specimens from patients with surgical resection were stained with HP immunohistochemical staining and Giemsa staining, and the clinical data were analyzed. Results Among the 42 patients with ITP, 36 (85.7%) were HP-infected patients and 3 (30%) were HP-infected patients in the normal control group. HP immunohistochemistry was positive in 12 patients in ITP group and HP immunohistochemistry in normal control group Positive in 1 case. The spleen tissue sections of ITP patients were subjected to Giemsa staining. The results of some sections were suspicious positive and negative in the normal control group. ITP patients infected with HP had no mild ITP, 4 moderate, 7 severe, and very severe 25. In ITP patients without HP infection, moderate, severe, and severe cases were all found in 2 patients without mild symptoms. Conclusion The presence of pathogen HP was confirmed in the spleen of ITP patients. HP infection is related to the severity of ITP.