血小板相关抗体在诊断ITP应用中的改进设想

Attempt to Improve the Application of Platelet-associated Immunoglobulin in the Diagnosis of Immune Thrombocytopenia

目的:提高血小板相关抗体诊断免疫性血小板减少性紫癜的特异性。方法:选择144例血小板计数低于100×109/L的患者,根据诊断分为ITP组和NITP组;用流式细胞术检测其外周血PAIgG,PAIgA,PAIgM;通过ROC曲线分析确定PAIgG,PAIgA,PAIgM有助于诊断ITP的水平。结果:PAIgG和PAIgM对ITP的最佳诊断界值分别为5%和10%,PAIgG单独诊断ITP的敏感性为71.43%,特异性为79.17%,PAIgG与PAIgM串联诊断ITP的敏感性为60.57%,特异性为87.5%。结论:流式细胞术检测PAIgG和PAIgM,联合ROC曲线分析,对ITP的诊断具有确切价值。

Objective To increase the specificity of detection the platelet-associated immunoglobulin （PAIg） in immune thrombocytopenia （ITP） patients. Methods Blood samples from 144 patients with a platelet count less than 100 × 10^9/L were used in this study. According to the diagnosis, patients divided into ITP group and NITP group. Flow-cytometry detection of PAIg was performed. ROC curve analysis was used. Results The cutoff value of posivity of PAIgG and PAIgM for the discrimination of ITP and non-ITP were 5% and 10% respectively. The sensitivity of a positive PAIgG test for ITP in thrombocytopenic patients was 71.43%, and the specificity was 79.17% individually. While, the sensitivity of a positive PAIgG and PAIgM test for ITP in thrembocytopenic patients was 60.57%, and the specificity was 87.5% separately. Conclusion This study demonstrated that flow-cytometry detection of PAIg combined with ROC curve analysis provides definite value for the diagnosis of ITP.