自身免疫性溶血性贫血患者IgG亚类与血细胞参数的相关性研究

Correlation of IgG Subclass with Blood Cell Parameters in Patients with Autoimmune Hemolytic anemia

目的:探讨自身免疫性溶血性贫血(AIHA)患者IgG亚类与血细胞参数的相关性。方法:选择本院2010年12月至2016年8月诊断为温抗体型AIHA(排除单纯C3d型)34例免疫复合型(IgG+C3d)和单IgG型的患者。其中原发性26例,继发性8例;男11例,女23例;平均年龄37.8(0.5-79)岁。健康对照者30名,男15名,女15名,平均年龄42.8(18-55)岁。采用酶联免疫的方法(双抗体夹心法),对30例健康对照者、34例AIHA患者及其中的32例患者红细胞放散液进行IgG亚类检测。结合患者血细胞部分参数,分析患者IgG亚类水平与血细胞部分参数的关系。2组间比较采用独立样本t检测,相关分析采用Spearman方法。结果:34例AIHA患者IgG1-4平均值高于30例健康对照者,2组比较差异有统计学意义(IgG1:t=-4.88,P<0.01;IgG2:t=-3.06,P<0.01;IgG3:t=-5.39,P<0.01;IgG4:t=-3.16,P<0.01)。而2组各亚类所占IgG的百分比比较显示,除IgG4外,其余3个亚类所占IgG的百分比均有统计学差异(IgG1:t=-4.03,P<0.01;IgG2:t=7.38, P<0.01;IgG3:t=-3.03,P<0.01;IgG4:t=1.73,P>0.05)。对34例AIHA患者血浆中IgG亚类与部分血细胞参数采用Spearman相关分析显示,IgG1与Hb、RBC、HCT呈正相关(Hb:r=0.358,P<0.05;RBC:r=0.426,P<0.05;HCT:r=0.363,P<0.05),IgG1、IgG2与WBC计数呈负相关(IgG1:r=-0.437,P<0.05;IgG2:r=-0.487,P<0.01),IgG2与PLT计数呈负相关(r=-0.436,P<0.05)。患者血浆和放散液中各亚类所占百分比比较显示,除IgG2无统计学意义外,其余3个亚类的百分比均有统计学差异(IgG1:t=6.528,P <0.01;Ig G2:t=1.544,P>0.05;Ig G3:t=-8.488,P<0.01;Ig G4:t=-9.434,P<0.05)。结论:AIHA与Ig G1和Ig G3相关,IgG亚类检测对研究AIHA的诊断、治疗及发病机理有一定意义。

Objective: To investigate the correlation of IgG subclasses with blood cell parameters in the patients with autoimmune hemolytic anemia(AIHA). Methods: Thirty-four patients with AIHA(except C3 d types) of immune complex type(IgG+C3d) and single IgG type, including 26 cases of primary AIHA and 8 cases of secondary AIHA from December 2010 to August 2016 in our hospital were selected and enrolled in AIHA group;30 healthy persons were selected and enrolled in healthy control group. The levels of IgG subclasses in blood plasma were detected by double antibody sandwich ELISA in healthy persons and AIHA patients, at the same time. The levels of IgG subclasses in of RBC diffuse fluid were detected as well. The relation of IgG subclass level with some parameters of blood cells was analyzed in the hight of partial parameters of blood cells in patients. The independent sample test was used for comparison of data in 2 groups, the Spearman method was used for correlation analyziz. Results: The average value of IgG1-4 in AIHA group was higher than that in healthy control group, there was statisticad difference between 2 groups(IgG1: t=-4.88, P<0.01;IgG2: t=-3.06. P<0.01;IgG3: t=-5.39, P<0.01;IgG4: t=-3.16, P<0.01), but the comparison of various. IgG subclass ratio in 2 groups showed that in addition to IgG4(t=1.73, P>0.01) the ratio pf IgG1, IgG2 and IgG3 all had the statistical differences(IgG1: t=4.03, P<0.01;IgG2: t=7.38, P<0.01;IgG3: t=3.03, P<0.01). The spearmen analysis of corrclation of IgG subclass in blood plasma of patients with partial parameters of blood cells showed that the IgG4 positivety correlated with Hb level, the RBC count and HCT(Hb: r=0.358, P<0.05;RBC: r=0.426, P<0.05;HCT: r=0.363, P<0.05);the IgG1 and IgG2 negatively correlated with WBC count(IgG1: r=0.437, P<0.05;IgG2: r=-0.487, P<0.01);the IgG2 negatively correlated with count(r=-0.436, P<0.05). The comparison of IgG subclass ratio in plasma and RBC diffuse fluid of patients showed that in addition to IgG2(t=1.544, P>0.05), the rest IgG1, 3 and 4 all had statistical differences(IgG1: t=6.528, P<0.01;IgG3: t=-9.488, P<0.05;IgG4: t=-9.434, P<0.05). Conclusions: The AIHA relates with IgG1 and IgG3, the detection of IgG subclasses may have a certain significance for studying the diagnosis, treatment and pothogenesis of AIHA.