特发性血小板减少性紫癜患者血小板相关抗体的表达及意义

目的探讨特发性血小板减少性紫癜（ITP）患者患病时PAIg的表达评价其在ITP中的临床意义。方法选取40例ITP患儿作为研究对象,同期门诊体检正常儿童20例为对照组,应用酶联免疫吸附法（ELISA法）测定血小板相关抗体（PAIgA、PAIgG）、采取单克隆抗体特异性俘获血小板抗原（MAIPA法）测定血小板特异性抗体抗血小板膜糖蛋白抗体（GPIIb/IIIa、GPIb/IX）,全自动血液分析仪测定血小板计数。结果 PAIgA、PAIgG、GPIIb/IIIa、GPIb/IX、血小板计数对照组分别为（4.22±0.78）ng/107PA、（23.17±3.46）ng/107PA、（0.33±0.01）A值、（0.31±0.01）A值、（137.82±42.37）×109/L,ITP组分别为（45.58±5.32）ng/107PA、（243.34±12.21）ng/107PA、（0.42±0.06）A值、（0.41±0.05）A值、（35.50±21.35）×109/L,两组以上各项指标之间比较均差异有统计学意义（P〈0.05）;ITP组血小板计数与特异性抗体GPIIb/IIIa、GPIb/IX之间具有负相关,相关系数分别为-0.24（P〈0.05）、-0.31（P〈0.05）。结论在ITP患儿中血小板相关抗体及特异性抗体均有明显升高,呈现阳性表达,ELISA法、MAIPA法联合检测有助于鉴别免疫性与非免疫性血小板减少型紫癜,能提高早期诊断率,并且有助于指导临床治疗。

The Expression and Significance of Platelet-associated Antibodies in Patients with Idiopathic Thrombocytopenic Purpura

Objective To understand the expression of PAIg in patients with idiopathic thrombocytopenic purpura （ITP） and evaluate its clinical significance in ITP. Methods 40 children with ITP were selected as the subjects, and 20 normal children underwent outpatient physical examination during the same period were selected as the control group. Enzyme linked immunosorbent assay （ELISA） was used to detect platelet-assoeiated antibodies （PAIgA, PAIgG）, monoclonal antibody immobilization of platelet antigen assay （MAIPA） was adopted to determine platelet specific antibodies against platelet membrane glyeoprotein antibody（GPIIb/IIIa, GPlb/IX）, and full automatic blood analyzer was used to determine the platelet count. Results The PAIgA, PAIgG, GPIIb/IIIa, GPIb/IX and platelet count respectively was （4.22±0.78）ng/107PA, （23.17±3.46）ng/107PA, （0.33±0.01）A, （0.31±0.01）A, （137.82±42.37） ×109/L in the control group, and respectively was （45.58±5.32）ng/107PA, （243.34±12.21）ng/107PA, （0.42±0.06）A, （0.41± 0.05）A, （35.50±21.35）×109/L in the control group, the differences between the two groups were statistically significant（P〈O.05）; the platelet count of the ITP group was negatively correlated with the specific antibodies GPIIh/IIIa and GPIhflX, the correlation coefficiant was -0.24（P〈0.05）, -0.31（P〈0.05）, respectively. Conclusion Platelet associated antibodies and specific antibodies increase significantly in children with ITP, and show positive expression; ELISA combined with MAIPA is help to differentiate immune thrombocytopenia purpura and non-immune thrombocytopenia purpura, which can improve the early diagnosis rate, and is conducive to guiding the chnical treatment.