特发性血小板减少性紫癜患儿血小板膜糖蛋白表达及临床意义

Expression of platelet membrane glycoproteins in pediatric idiopathic thrombocytopenic purpura and its clinical significance

目的检测儿童特发性血小板减少性紫癜（ITP）血小板膜糖蛋白（GP）的表达并探讨其临床意义。方法采用改良单克隆抗体特异性俘获血小板抗原（MAIPA）法检测80例ITP患儿GPⅠb／IX、GPⅡb、GPⅢa、GPIb的阳性表达率。分别观察总ITP患儿、不同性别ITP患儿、急慢性ITP患儿GP阳性表达率与ITP疗效的关系。结果80例ITP患儿中GP阳性组与阴性组的疗效比较差异有统计学意义（χ2=8．535，P〈0．01）；44例男性ITP患儿与36例女性ITP患儿GP阳性组与阴性组问疗效比较差异无统计学意义（χ2=0．013，P〉0．05），组内比较差异有统计学意义（男：χ2=4．156，P〈0．05；女：χ2=4．433，P〈0．05）；67例急性与13例慢性ITP患儿GP阳性组与阴性组问疗效比较差异有统计学意义（χ2=23．513，P〈0．001），急性ITP患儿组内比较差异有统计学意义（χ2=4．157，P〈0．05），慢性ITP患儿组内比较差异无统计学意义（χ2=0．410，P〉0．05）。结论儿童ITP患儿疗效与GP阳性表达率明显相关，GP阳性率在一定程度上可以反映患儿的病情程度，作为判断儿童ITP疗效及监测预后的指标之一。

Objective To explore the relationship between the expression of platelet membrane glycoprotein in pediatric idiopathic thrombocytopenic purpnra （ITP） and its clinical significance. Methods A modified monoclonal antibody immobilization of platelet antigen （MAIPA） method was used to detect the positive expression rates of 4 platelet membrane glyeoproteins （GP I b/IX, GP II b, GP III a, and GP I b） in 80 pediatric patients with ITP. The correlation was explored between the GP positive rate and the clinical efficacy in pediatric ITP. Trying to observe the correlationship between the GP positive rate of pediatric ITP in the total,the different gender,the acute and chronic and the treatment response rate in pediatric ITP respectively. Results There was a significant difference in curative rate statistically between the GP positive group and the GP negative group（ χ2= 8. 535 ,P 〈 0.01 ）in 80 pediatric ITP patients, but no statistic difference in curative rate existed between the 36 female and 44 male（χ2 =0. 013,P 〉0.05）. Markedly statis- tic difference was found in the female（χ2 =4. 433,P 〈0.05） ,the same to the male（χ2=4. 156,P 〈0.05）. Mean-while,there was an extremely statistic difference between 67 acute and 13 chronic patients（ χ2 = 23. 513,P 〈 0. 001 ）. Apparently statistic difference also occurred in the acute （ χ2 = 4. 157, P 〈 0.05 ）, but not in the chronic cases （ ~2 = 0. 410 ,P 〉0.05 ）. Conclusions The clinical response rate is significantly correlated with the GP positive rate in pediatric ITP, but not correlated with gender. The GP positive rate can reflect the disease status of pediatric ITP to a certain extent and be used as an indicator for judging the efficacy and monitor prognosis of pediatric ITP.