特发性血小板减少性紫癜患儿血小板生成素的变化及其意义

Changes and significance of thrombopoietin in children with idiopathic thrombocytopenic purpura

目的:探讨特发性血小板减少性紫癜(ITP)患儿治疗前后血清血小板生成素(TPO)水平变化及其对糖皮质激素治疗的预测价值。方法:采用酶联免疫吸附法,检测比较38例急性ITP(AITP)和17例慢性ITP(CITP)患儿激素治疗前后血清TPO浓度,并设正常对照。结果:治疗前AITP、CITP及对照组TPO异常率分别为84.2%、70.6%、10.3%,三者差异有显著性(P<0.05);治疗后异常率分别为26.3%,64.7%,10.3%,三者差异有显著性(P<0.05);治疗前AITP,CITP及对照组TPO水平比较三者差异有显著性(P<0.05),以CITP患儿TPO水平为最高。治疗前后比较,AITP组TPO水平差异有显著性(P<0.01),CITP组TPO水平差异无显著性(P>0.05)。结论:血清TPO水平低的AITP患儿激素治疗反应好,血清TPO水平高的CITP患儿激素治疗反应差,血清TPO水平可作为预测ITP患儿对糖皮质激素治疗反应的指标。

Objective: To observe the changes of serum thrombopoietin(TPO) in children with idiopathic thrombocytopenic purpura(ITP ) and the predictive evaluation for glucocor- ticoid theraphy. Method: The serum levels of TPO in 38 chlidren with acute ITP and 17 chlidren with chronic ITP were measured using sandwich-ELISA procedure before and after glucocorticoid theraphy, compared with control group. Results: The serum level of TPO in 38 chlidren with AITP slightly increased before glucocorticoid theraphy, and decreased after glucocorticoid theraphy with significant difference compared with untreated children(P<0.01). The serum level of TPO in 17 chlidren with CITP increased before glucocorticoid theraphy, and decreased after glucocorticoid theraphy with no significant difference compared with untreated children(P>0.05). Conclusion: ITP children with lower serum level of TPO have good response to glucocorticoid theraphy. ITP children with higher serum level of TPO have poor response to glucocorticoid theraphy. The serum level of TPO helps to predict the effect of glucocorticoid theraphy in ITP.