PAIgG及血小板活化标志物PAC-1、CD62P检测在原发性血小板减少性紫癜患者临床意义

The clinical significances of PAIgG,PAC-1 and CD62P in patients with idiopathic thrombocytopenic purpura

目的检测原发性血小板减少性紫癜(ITP)患者血小板相关抗体(PAIgG)及血小板活化标志物PAC-1、CD62P表达,以探讨其在ITP中应用价值。方法采用流式细胞仪分别对ITP患者、非免疫性血小板减少、其他自身免疫性疾病及正常对照组的PAIgG、PAC-1及CD62P的表达情况进行分析测定。结果 ITP患者PAC-1血小板阳性表达率45.7±17.6%明显高于其他三组患者11.4±4.2%,10.2±4.2%,11.7±5.6%(P【0.01),但CD62P血小板阳性表达率四组无明显差别,分别为3.4± 0.55%,3.1±0.52%,3.2±0.51%;3.4±0.53%(P】0.05);在32例ITP患者,21例表现为PAIgG阳性血小板百分率增高 (65.6%),23例表现为平均荧光强度(MFI)增高(71.9%),将PAIgG与MFI综合统计,对ITP患者阳性诊断率为84.4%(27/32); 无临床症状ITP患者的PAC-1活性表达为55.4±27.9%明显高于有临床症状ITP患者29.8±12.3%(P【0.01),PAIgG测定结果在两组间无明显差异(P】0.05)。结论 PAIgG对ITP诊断具有较高的阳性率,同时结合PAC-1,可提高ITP的诊断正确率; PAC-1可作为ITP患者疗效监测及判断预后的指标;CD62P并非监测ITP患者血小板活化的理想标志物。

Objective To detect the expression of platelet-associated immunoglobulin G(PAIgG) and the platelet activation glycoproteins CD62P,PAC-1,and to explore the functions and clinical significance of them in the patients with idiopathic thrombocytopenic purpura(ITP). Methods The expression of PAIgG,CD62P and PAC-1 was detected using flow cytometry(FCM)in patients with ITP,patients with non-immune platelet decrease,patients with other autoimmune disease and normal control.Results The expression of PAC-1(45.7%±17.6%)in patients with ITP is significantly higher than that of the other groups(11.4%±4.2%,10.2%±4.2%,11.7%±5.6%) (P<0.01),but expression of CD62P is not significantly different in the four groups(3.4%±0.55%,3.1%±0.52%,3.2%±0.51%,3.4%±0.53%)(P >0.05). In 32 patients with ITP,the positive ratio of PAIgG is 65. 6% (21/32),the positive ratio of mean fluorescence intensity (MFI) is 71.9%(23/32),the positive ratio of both PAIgG and MFI is significantly higher than that in ITP group with clinical symptoms(P<0.01),but PAIgG is not different in both ITP groups without and with clinical symptoms(P>0.05).Conclusion In patients with ITP positive ratio of PAIgG is higher,the correct diagnostic ratio of ITP is improved if PAIgG is combined with PAC-1,PAC-1 can be considered as a marker for curing effect and judging prognosis,and CD62P is not a ideal marker for platelet activation.