流式细胞术研究特发性血小板减少性紫癜患者血小板相关抗体

Application of flow cytometry in detecting platelet associated immune globulins in patients with idiopathic thrombocytopenic purpura

目的：探讨特发性血小板减少性紫癜（ITP）患者血小板表面相关抗体（PAIg）在诊断及预后的价值。方法：应用流式细胞术（FCM）检测84例ITP患者及20例正常人PAIgG、PAIgM、PAIgA。结果：初发ITP和复发ITP患者组与正常对照组比较，PAIgG、PAIgA差异有统计学意义（P〈0．01），PAIgM差异无统计学意义（P〉0．05）。PAIgM与PAIgA之间有显著相关性，r=0．451（P〈0．01）。结论：①PAIg增高可作为诊断初发ITP的重要指标之一；②FCM检测ITP患者血小板表面PAIg敏感性好、特异性高，适用于临床，对ITP的诊断及预后评价有较好的实用价值；③初发型ITP患者以PAIgG和PAIgA增高为主，预后较好；复发型以PAIgM增高为主，预后较差，易复发。

Objective：To explore the value of platelet associated immune globulin（PAIg） in the diagnosis and prognosis of idiopathic thrombocytopenic purpura（ITP）. Method：The PAIgG, PAIgM and PAIgA were detected by flow cytometry（FCM）in 84 patients with ITP and 20 healthy subjects. Result：ITP and relapse ITP groups were compared with control group,there existed significant difference in PAIgG and PAIgA （P〈0.01）, but existed no difference in PAIgM （P〉0.05）. There existed positive relationship between PAIgM and PAIgA in ITP patients, related coefficient r= 0. 451 （P〈0.01）. Conclusion： （1） The level of PAIg can be used as one of the important diagnosis criteria for ITP. （2）FCM can be as a routine method in diagnosis and evaluation of the therapeutic effects in patients with ITP because of its high sensitivity and specificity. （3）ITP patients with PAIgG and PAIgA increased have better prognosis, but relapsed ITP patients with PAIgM have bad prognosis and easily relapse.