特发性血小板减少性紫癜病人血浆可溶性IL-2受体水平及意义

为探讨特发性血小板减少性紫癜(idiopathic thrombocytopenic purpura,ITP)可溶性白细胞介素2受体(SIL-2R)的临床意义,用ELISA双抗夹心法动态检测了34例ITP病人血浆可溶性IL-2受体(SIL-2R)水平,并与34例正常人对照。结果显示,12例慢性ITP血浆SIL-2R水平明显高于正常对照组(P<0.001)和急性ITP组(P<0.01),而7例缓解期ITP病人血浆SIL-2R水平与正常组间无显著差异。经VLAP方案(长春新碱、左旋咪唑、氨肽素和泼尼松)治疗有效的急性及慢性ITP病人血浆SIL-2R水平均较治疗前明显降低(P<0.001),而治疗无效者无明显下降(P>0.05)。结论:T细胞活化与ITP病情发展有关,血浆SIL-2R水平可做为判断ITP预后的一个指标。

Plasma Soluble Interleukin-2 Receptor Level in Patients with Idiopathic Thrombocytopenic Purpura and Its Clinical Significance

To investigate contribution of soluble interleukin-2 receptor (SIL-2R) to the clinical progress of idiopathic thrombocytopenic purpura (ITP),SIL-2R levels were measured in the plasma of 34 patients and 34 normal controls with double antibody sandwich ELISA.The cohort consisted of 12 patients with chronic ITP,15 with acute ITP and 7 with ITP in remission.The results showed that the mean SIL-2R level of chronic ITP group was significantly higher than those of both the control and acute ITP group ( P < 0.001 and P < 0.01,respectively).The SIL-2R level of 1 cases in remission,however,was not significantly different from that of normal controls.Furthermore,the plasma levels were dramatically lowered in patients responsive to VLAP regimen ( vincristine,L-imidazole,antaisu and prednisone),and those were not evidently decreased in unresponsive patients.It was concluded that T cell activation may play a role in the development of ITP,and further,the level of plasma SIL-2R might predict the prognosis of ITP.