促血小板生成素和血小板特异性抗体在SLE合并血小板减少中的作用

Role of thromobopoietin and human platelet antibody in systemic lupus erythematosus with thrombocytopenia

目的:通过对系统性红斑狼疮(SLE)合并血小板减少患者血清中的促血小板生成素(TPO),血小板特异性抗体(HPA)以及各实验室指标的检测,分析TPO,HPA与各实验室指标的相关性,探究TPO及HPA与SLE合并血小板减少患者的关系,从而初步分析SLE合并血小板减少症的发病机制。方法:收集SLE合并血小板减少患者30例(SLE合并组),单纯SLE患者22例(SLE组),健康对照者18例(对照组),应用酶联免疫吸附法(ELISA)分别检测血清中TPO、HPA含量,应用免疫比浊方法检测SLE合并组C反应蛋白(CRP),类风湿因子(RF),补体C3,补体C4实验室指标,沉降法检测红细胞沉降率(ESR),电阻法检测血小板值,分析TPO与各实验室指标的相关性。结果:TPO含量在3组间差异有统计学意义(P<0.01);HPA阳性率在3组间差异无统计学意义(P>0.05)。在SLE合并组中,TPO与CRP(r=0.387,P=0.035)、血沉(r=0.669,P=0.001)呈正相关;与C3(r=-0.397,P=0.030)、C4(r=-0.462,P=0.010)呈负相关;与RF、血小板计数无相关性。结论:SLE患者血清中TPO含量明显升高,而HPA则无差异,TPO可能在SLE患者血小板减少作用机制中发挥一定作用。

Objective:To analysis thromobopoietin/human platelet antibody(TPO/HPA)and laboratory markers in systemic lupus erythematosus(SLE),to explore the relationship between TPO/HPA and SLE merging thrombocytopenia,to discuss the pathogenesis of SLE combined thrombocytopenia.Method:TPO and HPA were measured in thirty patients with SLE merging thrombocytopenia,22 patients with SLE and 18 matched health controls.To measure CRP,RF,C3,C4,erythrocyte sedimentation tate(ESR)and platelet count in SLE merging thrombocytopenia.Result:TPO level in serum comparisons among SLE merging thrombocytopenia group,SLE group and the normal control group were significant difference(P<0.01).No significant difference for HPA was found among SLE merging thrombocytopenia group,SLE group and the normal control group.In SLE merging thrombocytopenia group,TPO was negatively associated with C3(r=-0.397,P=0.030),C4(r=-0.462,P=0.010),positively correlated with CRP(r=0.387,P=0.035),ESR(r=0.669,P=0.001),but not with RF,platelet count.Conclusion:The level of serum TPO in SLE patients were higher than healthy group,but the differences of HPA were no significant among three groups of SLE patients.It suggested TPO had taken part in the pathology of SLE merging thrombocytopenia.