过敏性紫癜患者外周血中性粒细胞CD11b及血浆弹性蛋白酶的检测

Expression of neutrophil adhesion molecule CD11b and plasma levels of elastase in patients with anaphylactoid purpura

目的探讨不同病期过敏性紫癜患者外周血中性粒细胞表面黏附分子CD11b的表达及血浆弹性蛋白酶活性的变化及其与疾病活动性的关系。方法采用流式细胞仪检测12例过敏性紫癜患者活动期及缓解期外周血中性粒细胞表面黏附分子CD11b表达的变化，并与12例正常人进行比较。采用ELISA法检测20例过敏性紫癜患者活动期及缓解期血浆弹性蛋白酶水平的变化，并与20例正常人进行比较。结果活动期患者外周血中性粒细胞CD11b的表达及血浆弹性蛋白酶水平明显高于缓解期（P均〈0．01）；缓解期患者外周血中性粒细胞CD11b的表达与正常人对照组比较，差异无统计学意义（P〉0．05）；缓解期患者血浆弹性蛋白酶水平仍高于正常人对照组（P〈0、05）。在活动期，外周血中性粒细胞CD11b的表达与血浆弹性蛋白酶水平呈正相关（r=0．73，P〈0．01）；而缓解期两者无显著相关性（r=0．20，P〉0．05）。结论过敏性紫癜患者外周血中性粒细胞处于激活状态，活动期较缓解期更明显。

Objective To explore the expression ofneutrophil adhesion molecule CD11b, and plasma level of elastase in patients with anaphylactoid purpura during different clinical phases and their correlation with disease activity. Methods A total of 20 patients with anaphylactoid purpura were recruited into this study, along with 20 normal human controls. Two blood samples were collected from each patients at the first visit （active phase） and after 3 - 5 weeks of treatment （remission phase）. The expression of CD11b was measured by flow cytometry in 12 patients and normal controls, and plasma levels of elastase by ELISA in 20 patients and normal controls. Results Increased CD11b expression and elastase level were noted in patients in active phase compared with those in patients in remission phase （3367.25±434.57 vs 2569.33±411.06, 13.98±2.05 vs 4.29±0.80, both P 〈 0.01 ）. No significant difference was found in CD11b expression between patients in remission phase and normal controls （P 〉 0.05 ）, while the elastase level was higher in patients in remission phase than in normal controls （4.29±0.80 vs 3.67±0.54, P〈 0.05）. In active phase of anaphylactoid purpura, the expression of CD11b was positively correlated with the plasma level of elastase （r = 0.73, P 〈 0.01）, while no correlation was noticed between them in remission phase （r = 0.20, P = 0.54）. Conclusion Peripheral neutrophils are activated in anaphylactoid purpura, which seems to be more obvious in active phase than in remission phase.