特发性血小板减少性紫癜患者血小板生成素和β_2-微球蛋白与疗效的关系

An Observation on Relationship of Thrombopoietin and Beta2-microglobulin with the Curative Results of Idiopathic Thrombocytopenic Purpura

目的:探讨特发性血小板减少性紫癜(ITP)患者血清血小板生成素(TPO)和β2-微球蛋白(β2-M)与疗效的关系。方法:初治ITP患者,分为治疗有效组和治疗无效组,设正常对照组20例;采用双抗体夹心酶联免疫吸附法(ELISA)和放射免疫法(RIA),分别检测治疗前后血清TPO和β2-MG。同时检测治疗前骨髓涂片的平均巨核细胞数量。结果:在ITP患者中,治疗无效组的TPO和β2-M则明显高于有效组及对照组(P<0.05),有效组与对照组间无显著差异(P>0.05),而巨核细胞计数则显著低于有效组(P<0.01);治疗后,治疗无效组的β2-M和TPO水平仍明显高于对照组(P<0.05),有效组和无效组治疗后的TPO和β2-M水平略有下降,但差异无统计学意义(P>0.05)。结论:血清高水平TPO和β2-M可能预示ITP治疗困难,表明治疗有效与无效的ITP患者在发病机理方面可能存在差异。

Objective： To investigate the relationship of serum thrombopoietin （TPO）, and beta-2mieroglobulin （β2-M） with the curative results of idiopathic thromboeytopenie purpura （ITP）. Methods： Thirty patients with newly diagnosed ITP were divided into effective group （group E, n = 23） and ineffective group（ group I, n = 7 ）, according to their curative results. The serum TPO coneentrations of all of the patients and 20 healthy people （ as control, group C） were detected by using double-antibody sandwich enzyme-linked immunosorbent assay （ELISA） , and the serum β2-M concentrations were detected by using radio-immunoassay （RIA）. Bone marrow megakaryocytes were counted before the treatment of ITP. Results： The megakaryoeyte counts of patients in group I were significant- ly lower than that of patients in group E （P 〈0.01 ） ; The TPO and β2-M levels of patients in group I were significantly higher than those of patients in group E and healthy people in group C （ P 〈 0.05 ）, and kept significantly higher than those of group C after a period of treatment （ P 〈 0.05 ）. The TPO and β2-M levels of the patients in two groups did not change significantly before and after the treatment （ P 〉 0.05 ）. Conclusions： High levels of serum TPO and β2-M in ITP patients may be a sign indicating the difficulty in treatment, and there might be some differences in pathogenesis between ＂effectively cured＂ and ＂difficultly-treat＂ ITP patients.