血小板特异性抗体检测对免疫性与非免疫性血小板减少症的鉴别诊断价值

The differential diagnosis value of detection of platelet specific autoantibody on idiopathic thrombocytopenic purpura and non-ITP

目的检测特发性血小板减少性紫癜(ITP)患者及非免疫性血小板减少症患者(Non-ITP)的抗血小板膜糖蛋白(GP)Ⅱb/Ⅲa、抗GPⅠb/Ⅸ血小板特异性抗体表达,并比较其对ITP的鉴别诊断价值。方法应用改良血小板抗原单克隆抗体固相化检测技术(MAIPA)检测ITP患者、Non-ITP患者抗GPⅡb/Ⅲa、抗GPⅠb/Ⅸ特异性抗体。结果 ITP组抗GPⅡb/Ⅲa、GPⅠb/Ⅸ抗体的总阳性率均高于Non-ITP组,差异有统计学意义(χ2=6.522,P<0.05)。男、女及急、慢性ITP患者间抗GPⅡb/Ⅲa及抗GPIb/Ⅸ抗体阳性率差异均无统计学意义(P均>0.05)。结论抗GPⅡb/Ⅲa、抗GPⅠb/Ⅸ特异性抗体检测对ITP的鉴别诊断具有较高的价值,同时二者对ITP诊断的敏感度、特异度无差异,具有一定的临床应用价值。

Objective To detect the expressions of anti-GPⅡb/Ⅲa and anti-GPIb/Ⅸ specific autoantibodies in patients with idiopathic thrombocytopenic purpura（ITP） and patients with non-ITP,and to compare their differential diagnosis value on ITP.Methods The expressions of anti-GPIIb/Ⅲa and anti-GPIb/Ⅸ specific autoantibodies in patients with ITP and non-ITP were tested with monoclonal antibody immobilization of platelet antigens assay（modified MAIPA）.Results The total positive rates of anti-GPⅡb/Ⅲ and anti-GPIb/Ⅸ autoantibodies in ITP group were all higher than those in non-ITP group（χ2=6.522,P〈0.05）.No difference was found in the positive rates of anti-GPIIb/Ⅲ and anti-GPⅠb/Ⅸ autoantibodies among males,females and patients with acute and chronic ITP（both P〈0.05）.Conclusion The detection of anti-GPⅡb/Ⅲand anti-GPⅠb/Ⅸ autoantibodies had a relatively high specificity on the differential diagnosis of ITP.Meanwhile,the expressions of anti-GPⅡb/Ⅲand anti-GPⅠb/Ⅸ autoantibodies had no difference in sensitivity and specificity of ITP diagnosis,with certain clinical application value.