抗血小板膜糖蛋白Ⅱb/Ⅲa单克隆抗体对原发性血小板减少性紫癜诊断价值的研究

Study on the Diagnostic Value of Aatiplatelet Membrane GPⅡb/Ⅲa Monoclonal Antibodies in Idiopathic Thrombocytopenic Purpura

目的 旨在探讨血小板膜糖蛋白 b/ a单克隆抗体 ( b/ a Mc Ab)检测对原发性血小板减少性紫癜 (ITP)的诊断价值。方法 共检测成人慢性 ITP1 1 4例 ,应用 b/ a Mc Ab(SZ- 2 1 +SZ- 2 2 )与 ITP患者的血小板共同孵育 ,用吸光度计检测其吸光度值并与正常值相比较 (做为结合值 ) ,如此值 <0 .5为阳性 ,即判定患者血小板膜上原已结合有抗 b/ a的自身抗体。同时用竞争性酶联免疫吸附法检测患者的血小板相关 Ig G(PA Ig G)。以非 ITP性血小板减少患者做为对照组。结果 1 1 4例成人慢性 ITP中 ,GP b/ a检测阳性率为 49% ;非 ITP组无 1例假阳性。ITP组 PAIg G阳性率为 6 4 % ;非 ITP组假阳性率为 2 6 .6 %。结论 实验证实本检测法特异性好 ,操作简单技术稳定 ,对 ITP的诊断、疗效观察及发病机理研究具有实用价值。

Objective The value of antithrombocyte membrane glucoprotein Ⅱb/Ⅲa monoclonal antibodies (GPⅡb/Ⅲa McAb)as a useful tool in diagnosing idiopathic thrombo-cytopenic purpura (ITP)was investigated.Methods The 114 adult patients with chronic ITP were assayed.The ITP pletelets were incubated with GPⅡb/Ⅲa McAb (SZ-21+SZ-22)togather.After incubation,the light density was assayed by densitometer,and the value were cpmpared with normal control value(as a combinative value).The combinative value being lower than 0.5 was positive reaction.The judgement of existing anti-platelet autoantibodies on the platelet membrane already would be made.Meanwhile PAIgG was detected in the same ITP patients by means of competitive ELISA.The non-ITP thrombocytopenic patients were as the control group.Results The positive rate for GPⅡb/Ⅲa McAb was 49%;and not a signgle false positive reaction was found in non-ITP thrombocytopenic group.The posi-tive rate for PAIgG in ITP group was 64%;but with the 26.2% false positivty in non-ITP group.Conclutions This study showed that the technique is highly specific,easy to perform and provides reasonable reproducibility,and it proves to be a valuable method for the diagnosis and a parameter for the treatment efficiency of ITP,giving an insigth into its pathogenesis