特发性血小板减少性紫癜患者血小板生成素及血小板相关抗体检测

Detection of Thrombopoietin and Platelet Associated Antibody in the Patients with Idiopathic Thrombocytopenic Purpura

目的检测特发性血小板减少性紫癜(ITP)患者血小板生成素水平、T淋巴细胞亚群及血小板相关抗体的变化,探讨其在ITP发病机制中的作用及临床意义。方法应用夹心酶联免疫吸附试验、流式细胞术分别检测50例ITP患者和24例正常对照血小板生成素浓度、T淋巴细胞亚群及血小板相关抗体的比值。结果ITP患者的血小板计数为30.65±18.34×109/L明显低于正常对照组的226.63±45.63×109/L(P<0.05);血小板生成素水平二者的差异无显著性(分别为76.65±32.50 pg/ml,71.62±23.03 pg/ml,P>0.05);在T淋巴细胞亚群变化中,ITP患者CD 3+T淋巴细胞百分比、CD 4+T淋巴细胞百分比及CD 4+/CD 8+的比值分别为60.06±12.08%、27.74±9.67%、1.11±0.34%,均明显低于正常对照组(分别为69.89±5.56%、35.87±4.07%、1.64±0.32%,P<0.05),CD8+T淋巴细胞为31.12±12.49%则显著高于正常对照组(22.53±4.12%,P<0.05);ITP患者血小板相关抗体PAIgG 27.19±17.43%、PAIgM41.15±15.62%、PAIgA33.18±16.37%,均显著高于正常对照组(PAIgG9.28±3.85%、PAIgM16.78±9.26%、PAIgA22.12±8.86%,P<0.05)。结论血小板生成素、T淋巴细胞亚群及血小板相关抗体能较好地反映ITP的发病机制,对提高ITP诊断水平及指导临床治疗有一定的意义。

Objective Detecting the level of thrombopoietin and the percentage of T lymphocyte subsets and platelet associated antibody in the patients with idiopathic thrombocytopenic purpura（ ITP）, to investigate their pathogenesis and clinical significance. Methods The level of thrombopoietin and the percentage of T lymphocyte subsets and platelet associated antibody in 50 ITP patients and 24 healthy controls were tested by virtue of sandwich enzyme-linked immunosorbent assay and flow cytometry respectively. Results Compared with the controls（226.63 ±45.63 × 10^9/L） , the counts of platelets in ITP patients（30.65± 18.34 × 10^9/L, P 〈 0.05 ）. However, there was no apparent difference of the level of thrombopoietin between ITP patients and health controls （76.65 ±32.50 pg/ml ,71,62 ± 23.03 pg/ml respectively, P 〉 0.05 ）. In T lymphocyte subsets, the percentage of CD 3 ^＋ T lymphocyte and CD 4 ^＋ T lymphocyte and the ratio of CD 4 ＋/CD 8 ^＋ in patients with ITP （60.06 ± 12.08% ,27.74 ±9.67% , 1.11±0.34% respectively） were notably decreased than those healthy controls （of which those of control group were 69.89 ±5.56% ,35.87± 4.07%, 1.64± 0.32% respectively, P 〈 0.05 ）, but the percentage of CD 8 ^＋ T lymphocyte was significantly elevated （ which were 31.12± 12.49% and 22.53 ± 4.12% respectively, P 〈 0.05）. The percentage of PAIgG, PAIgM, PAIgA were apparently increased in ITP patients （which were 27.19± 17.43% ,41.15 ± 15.62% and 33.18 ±16.37% ）than health controls （which were 9.28 ±3.85% ,16.78±9.26% ,22.12 ±8.86% ,all P 〈0. 05 ）. Conclusion Thrombopoietin with T lymphocyte subsets and platelet assoeiated antibody in the patients with ITP, were reflect the pathogenesis of ITP, could be able to improve the diagnosis and guide clinical therapy.