原发性血小板减少性紫癜患者血小板抗体的表达及其对血小板数量和功能的影响

Platelet Autoantibody and Its Impact on Platelet in Patients with Idiopathic Thrombocytopenic Purpura

目的检测原发性血小板减少性紫癜(ITP)患者血小板抗体,并探讨其对血小板数量及功能的影响。方法采用单克隆抗体俘获血小板抗原技术(MAIPA)检测ITP患者、非原发性血小板减少患者及健康人血小板抗体,并在健康人富血小板血浆中加入ITP患者血清,观察其对健康人血小板聚集功能的影响。结果MAIPA法对ITP患者主要血小板自身抗体的检出率为65.4%,ITP患者中抗血小板抗体阳性者血小板数量明显低于抗体阴性者,且血小板数量与抗体水平呈负相关,其中GPⅡb/Ⅲa抗体阳性患者的血小板数量与GPⅡb/Ⅲa抗体水平呈负相关(r=-0.724);GPⅠb/Ⅺ抗体阳性患者的血小板数量与GPb/抗体水平呈负相关(r=-0.571),26例患者中10例血清抑制了健康人血小板聚集功能,其中9例为抗血小板抗体阳性患者,仅1例为抗体阴性患者。结论ITP患者血小板抗体不仅影响血小板数量,还对血小板功能有影响。

Objective To detect the platelet autoantibody in the patients with idiopathic thrombocytopenic purpura （ITP）and to investigate the impact of the autoantibody on the count and function of platelet. Methods The glycoprotein specific autoantibody was measured by MAIPA in the ITP patients, non-ITP patients and healthy people. The serum of the ITP patients were added to the healthy plasma with rich platelet and the platelet aggregation function was measured. Results The platelet autoantlbody was found in 65.4% of the ITP patients. The platelet counts in the ITP patients with positive autoantibody were significantly lower than those without the autoantibody. The platelet counts were negatively correlated with the levels of the autoantibody, with a correlation coefficient of --0. 724 for the anti GP I b/｜ a autoantibody and --0. 571 for the anti GP I b/IX autoantibody. The aggregation of normal platelets was inhibited in ten out of the 26 patients, among whom nine had platelet autoantibody. Conclusion The platelet autoantlbody affects not only the count but also the function of platelet.