ANA及ANAs表达对原发免疫性血小板减少症患者临床疗效及预后的影响

Effects of ANA and ANAs expression on the clinical effect and prognosis of patients with primary immune thrombocytopenia

目的探讨抗核抗体(ANA)及抗核抗体谱(ANAs)自身抗体表达对新诊断原发免疫性血小板减少症(ITP)患者临床疗效及预后的影响。方法回顾性分析2010年1月至2015年5月符合初治ITP条件的116例患者,均经ANA及ANAs筛查,根据自身抗体表达分组,阴性为对照组,阳性为试验组,对两组患者的临床治疗效果作对比分析,并且分析患者3年的死亡及疾病转归情况。结果试验组和对照组总有效率分别为80.0%和85.2%,差异无统计学意义(P>0.05);两组复发率分别为27.2%和13.5%,差异无统计学意义(P>0.05);两组单药有效率分别为72.7%和73.1%,差异无统计学意义(P>0.05);两组联合用药有效率分别为26.9%和27.2%,差异无统计学意义(P>0.05);试验组病死率及疾病转化率分别为14.5%及34.5%,均高于对照组1.6%及0,差异有统计学意义(P<0.01)。结论ANA及ANAs表达对ITP患者的近期临床疗效无明显影响,但是对ITP患者的长期预后有一定的不良影响。

Objective To investigate the effects of the expression of anti-nuclear antibody(ANA)and anti-nuclear antibody spectrum(ANAs)autoantibody on the clinical efficacy and prognosis of patients with newly diagnosed primary immune thrombocytopenia(ITP).Methods A retrospective analysis was made on 116 patients who met the ITP criteria from January 2010 to May 2015.All patients were screened by ANA and ANAs.They were grouped according to the expression of autoantibodies.Negative patients were the control group and positive patients were the experimental group.Results The total effective rates of the experimental group and the control group were 80.0%and 85.2%,respectively,with no significant difference(P>0.05);the recurrence rates of the two groups were 27.2%and 13.5%,respectively(P>0.05);the single drug effective rates of the two groups were 72.7%and 73.1%,respectively(P>0.05);The mortality and disease transformation rates of the experimental group were 14.5%and 34.5%respectively,which were higher than those of the control group(1.6%and 0)(P<0.01).Conclusion The expression of ANA and ANAs has no significant effect on the short-term clinical efficacy of ITP patients,but the expression of these autoantibodies has some adverse effects on the long-term prognosis of ITP patients.