血小板相关抗体在特发性血小板减少性紫癜诊治中的临床意义

Clinical significance on Platelet-associated antibodies in patients with idiopathic thrombocytopenia purpura

目的探讨流式细胞术检测血小板相关抗体在特发性血小板减少性紫癜(ITP)诊治中的意义。方法应用流式细胞术检测31例ITP患者、12例继发免疫性血小板减少(SITP)患者2、0例正常对照者的PAIgG、PAIgM、PAIgM水平。结果 ITP组、SITP组与正常对照组比较,PAIgG、PAIgM差异有统计学意义(P<0.05),PAIgA差异无统计学意义(P>0.05)I。TP组与SITP组比较,PAIgG、PAIgM差异有统计学意义(P<0.05),PAIgA差异无统计学意义(P>0.05)。11例急性ITP患者PAIgG、PAIgM水平治疗后较治疗前显著下降(P<0.05)。根据血小板降低程度将ITP患者分为轻、中、重度减低组,各组间PAIgM的平均荧光强度比较差异有统计学意义(P<0.05),血小板减低程度与PAIgM有关。结论 PAIgG、PAIgM可作为ITP诊断的辅助指标,不能用于ITP和SITP的鉴别,PAIgM的升高更易加速血小板破坏。

Objective To investigate the significance on platelet-associated antibodies detected by flow cytometry in patients with idiopathic thrombocytopenia purpura（ITP）.Methods The PAIgG,PAIgM,PAIgM was detected in 31 patients with ITP,12 patients with secondary immune thrombocytopenia（SITP） and 20 healthy subjects.Results 1） The PAIgG or PAIgM values in ITP and SITP were higher than that in controls,however,there was no significant difference in PAIgA between ITP or SITP with controls.2） The PAIgG or PAIgM values in 11 patients with acute ITP decreaced significantly afer treatment with prednisone.3） The levels of thrombocyte were more related with PAIgM.Conclusion PAIgG,PAIgM can be used as a clue for the diagnosis of ITP,however,they can not be used to differenciate ITP from SITP.The increase of PAIgM may accelerate the damage to thrombocyte.