血浆可溶性选择素的检测及其在儿童ITP发病中的意义

Detection of plasmic solubility selectins in ITP and their signifieance in invasion of puerile ITP

目的探讨血浆可溶性选择素在儿童特发性血小板减少性紫癜(ITP)发病中的意义。方法选取40例儿童ITP患者,其中急性病例25例,慢性15例,在接受激素或丙种球蛋白冲击治疗前采集清晨空腹全血。对照组为15例健康体检儿童,采集清晨空腹全血。所有血液标本均先检测即时血小板计数,然后分离血浆检测可溶性选择素。结果ITP组血浆可溶性P-选择素(sP-selectin,sP)浓度均明显低于对照组(P<0.05),而每个血小板所表达的sP浓度(sP/Ph)浓度高于对照组10倍左右,其中急性组又明显高于慢性组(P<0.05)。此外,ITP组血浆可溶性E-选择素(sE-selectin,sE)浓度明显高于对照组(P<0.05),血浆可溶性L-选择素(sL-selectin,sL)浓度稍高于对照组,但无统计学意义(P>0.05)。结论ITP患儿体内存在血管内皮细胞活化,活化的内皮细胞可能是ITP病人体内可溶性P-选择素的主要来源,可溶性选择素P、E可能参与了ITP病人致敏血小板。

Objective To investigate the significance of plasmic solubility selectins in invasion of puerile ITP. Methods To select 40 cases of puerile ITP（ include 25 acute cases and 15 chronictty cases） and 15 healthy children. Before they accept therapy of hormone or gamma globulin,we collect their whole blood in morning before their breakfast. Detect the number of platelet at once, then, separate the plasma. Finally, detect the concentration of each plasmic solubility selectin. Results The concentration of sP-selectin in puerile ITP descent（ P 〈 0. 05 ）, but The concentration of single platelet＇s sP-selectin （sP/Ph） increase 9 times （ P 〈 0. 05 ） , and the concentration of sP/Ph in acute eases is higher than in chronieity eases （ P 〈 0. 05 ）. The concentration of sE-selectin in puerile ITP increase （ P 〈 0. 05 ） , also sL-selectin＇s concentration increase, but it has not significance （P 〉 0. 05）. Conclusion Vascular endothelial cells are activate in puerile ITP, they may be the origin of plasmie solubility seleetins, and plasmie solubility seleetins may be mediate the migration of the sensitized platelets to spleen.