血小板抗体及标志物检测在特发性血小板减少性紫癜患者诊断中的价值

The diagnosis value of platelet-associated immunoglobulin G and the platelet ac tivation glycoproteins in patients with idiopathic thrombocytopenic purpura

目的 探讨血小板相关抗体 (PAIgG )和血小板活化标志物GPⅡb/Ⅲa及CD62P表达在特发性血小板减少性紫癜 (ITP)患者中诊断价值。方法 采用流式细胞术分别对ITP患者及各对照组的PAIgG、GPⅡb/Ⅲa及CD62P的表达情况进行分析测定。 结果 ITP患者组GPⅡb/Ⅲa血小板阳性表达率明显高于其他各组 (P <0 0 1) ,CD62P血小板阳性表达率 4组间差异无显著意义 (P >0 0 5) ;在 53例ITP患者中 ,3 4例表现为PAIgG阳性血小板百分率增高 (64 2 % ) ,3 8例表现为平均荧光强度 (MFI)增高 (71 7% ) ,将PAIgG与MFI综合统计 ,对ITP患者阳性诊断率为 84 9% (45/53 ) ;无临床症状ITP患者的GPⅡb/Ⅲa活性表达明显高于有临床症状ITP患者 (P <0 0 1)。结论 PAIgG对ITP诊断具有较高的阳性率 ,同时结合GPⅡb/Ⅲa ,可提高ITP的诊断正确率 ;GPⅡb/Ⅲa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 study on the diagnosis value of platelet- associated immunoglobulin G (PAIgG) and the platelet activation glycoproteins CD62P、GPⅡb/Ⅲa in the patients with idiopathic thrombocytopenic purpura (ITP). Methods The expression of PAIgG、CD62P and GPⅡb/Ⅲa in patients with ITP and control groups were detected by use of flow cytometry (FCM). Results The expression of GP Ⅱb/Ⅲa in patients with ITP was significantly higher than that of the other groups, but the expression of CD62P was no different in the four groups( P >0 05). In 53 ITP patients, the positive rate of PAIgG was 64 2% (34/53), the positive rate of mean fluorescence intensity (MFI) was 71 7% (38/53), the positive rate of both PAIgG and MFI was 84 9% (45/53). The expression of GPⅡb/Ⅲa in ITP group without clinical symptoms was significantly higher than that in ITP group with clinical symptoms ( P <0 01).Conclusion In ITP patients, positive rate of PAIgG was higher, the correct diagnostic rate of ITP was improved if PAIgG was combined with GPⅡb/Ⅲa; GPⅡb/Ⅲa can be considered as a marker for curing effect and judging prognosis. CD62P was not an ideal marker for platelet activation.