过敏性紫癜患儿血小板膜糖蛋白Ⅱb、Ⅲa及sICAM-1改变的临床意义

Expression and significance of phtelet membrane glycoproteins and intercellular adhesion molecules-1 in patients with anaphylactoid purpura

目的探讨过敏性紫癜患儿血小板膜糖蛋白Ⅱb、Ⅲa及sICAM-1表达量的变化及其临床意义。方法以单克隆抗体为探针,采用流式细胞仪检测52例过敏性紫癜患者血小板膜表面糖蛋白(Ⅱb,CD41)、血小板颗粒膜糖蛋白(Ⅲa,CD62P)的表达水平;同时采用ELISA法检测可溶性细胞间黏附分子-1(sICAM-1)在不同病期和分型时的表达水平。结果过敏性紫癜患儿急性期Ⅲa及sICAM-1表达水平明显高于缓解期和对照组,差异有统计学意义,Ⅱb表达水平无明显变化。紫癜肾炎型Ⅱb、Ⅲa及sICAM-1表达水平与混合型比较,差异无统计学意义。紫癜肾炎型及混合型与单纯皮肤型比较,Ⅲa及sICAM-1高于后者,差异有统计学意义。结论过敏性紫癜患儿存在血小板活化,其与过敏性紫癜病程变化关系密切。

Objective To investigate the expression and significance of platelet membrane glycoproteins and intercellular adhesion molecules-1 in patients with anaphylactoid purpura. Methods Fifty-two patients with anaphylactoid purpura were divided into three groups according to their clinical manifestations. 16 in dermal purpura group,20 in mixed group and 16 in nephritis group. The expression of Ⅱ b and Ⅲa in these 52 patients was detected by flow cytometry. The level of intercellular adhesion molecules-1 was analysed by ELISA with monoclonal antibody as the probe. Results The percentage of Ⅲa and ICAM-1 in patients in acute phase were significantly higher than those in regressive phase and those in normal control. Neither of the expression of Ⅱb and Ⅲ a nor the level of ICAM-1 in nephritis group was significantly different from that in the mixed group. Compared with dermal purpura group, the percentage of CD62P and ICAM-1 was significantly higher in the nephritis group and mixed group. There was no significant difference in Ⅱb expression among all groups. Conclusion The activation of platelet could be closely related to the progress of anaphylactoid purpura.