特发性血小板减少性紫癜血小板相关抗体分析

The Assay of Platelet-Associated Antibodies(PAIg)in Idiopathic Thrombocytopenic Purpura

目的 :探讨血小板相关抗体 (PAIg)与特发性血小板减少性紫癜 (ITP)的关系。方法 :采用ELISA法检测 10 8例ITP患者及 10 8例继发性血小板减少症患者PAIg (PAIgG、PAIgA、PAIgM) ,并计算三种指标灵敏度及特异度。结果 :①灵敏度 :PAIgG >PAIgM >PAIgA :PAIgG特异度 77 8%。②PAIgG在ITP组高于继发性血小板减少症组 (P <0 0 5 )。③对 36例急性ITP患者不同血小板数量组间PAIgG分析 ,结果示血小板数量越低 ,PAIgG均值越高 ,0～ 10× 10 9/L组 ,10～ 30× 10 9/L组 ,30～ 80× 10 9/L组间PAIgG结果有统计学差异 ,P <0 0 0 1)。④ 8例急性ITP患者治疗前后PAIgG明显高于普通ITP组 ,且伴有PAIgM升高。⑥低巨核细胞型ITP患者PAIgM均升高 ,治疗前后PAIgM有统计学差异 (P <0 0 5 )。结论 :血小板相关抗体PAIg是ITP患者诊断、治疗反应的有用指标。难治性或低巨核细胞型ITP患者除有PAIgG升高外 。

Objective:To investigate the relationship between platelet-associated antibodies(PAIg)and idiopathic thrombocytopenic purpura.Methods:PAIg(PAIgG?PAIgA?PAIgM)was examined by ELISA of 108 ITP patients and 108 secondary thrombocytopenia patients and caculate the sensitivity and specificity of 3 indexs.Results:①The sensitivity was PAIgG>PAIgM>PAIgA.The specificity of PAIgG was 77.8%?②The PAIgG of ITP group was higher than that for the groups of secondary thrombocytopenia(P<0.05).③To analysis the PAIg among with the different platelet number groups of the acute ITP:the PAIgG in which three groups among with 0～10×10 9/L group?10～30×10 9/L group,30～80×10 9/L group had significant statistic difference(P<0.01).④The PAIgG had significant statistic difference between protreat and posttreat for 8 ITP patients.⑤The PAIgG of 3 refractory ITP was significant higher than that of the control group,and accompanyed with PAIgM rising.⑥The PAIgMs of megalokaryocytopenia ITP were all rised.PAIgM had sigificant statistic difference between before treatment and after treatment(P<0.05).Conclusion:PAIg may be an useful index for ITP on diagnosis and treatment reaction beside PAIgG rised,refiractory or me yalokargocytopenia ITP were all accompanied with PAIgM rising.