血小板特异性自身抗体检测在特发性血小板减少性紫癜中的意义  

Significance of specific autoantibodies against platelet glycoprotein in Idiopathic thrombocytopenic purpura.

作　　者：鲍静[1] 倪合宇[2] 夏瑞祥[1] 曾庆曙[1] 

机构地区：[1]安徽医科大学第一附属医院血液内科,合肥230022 [2]加拿大多伦多大学实验医学与病理生物学系

出　　处：《中国综合临床》2008年第9期861-863,共3页Clinical Medicine of China

基　　金：安徽省科技厅重点科研计划项目（07020303076）

摘　　要：目的 检测特发性血小板减少性紫癜（ITP）患者体内的血小板特异性自身抗体与临床严重程度和临床疗效间的关系。方法 应用改良的单克隆抗体特异性俘获血小板抗原（MAIPA）法检测血小板膜糖蛋白（GPⅡbⅢa,GPIb）特异性自身抗体。结果ITP组（40例），10例为单一抗GPⅡbⅢa抗体阳性，6例为单一抗GPIbα抗体阳性，20例为双抗体阳性，4例为双抗体阴性。非免疫性血小板减少组与正常对照组均为阴性。抗GPⅡbⅢa抗体（b=-0．071，P〈0．01）、抗GPIbot抗体（b=-0．092，P〈0．01）均与采血时血小板计数呈显著负相关。治疗后，双抗体阳性组8例治疗无效，单抗体阳性组（16例）1例治疗无效（Х^2=6．09，P〈0．05）。结论 血小板特异性自身抗体检测对鉴别特发性和非免疫性血小板减少症有一定价值，抗体种类与临床疗效有一定关系。Objective To detect the specific autoantibodies against platelet in idiopathic thrombocytopenic purpura （ ITP ） and to study the relationship between these autoantibodies and the severity of ITP as well as therapeutic effect. Methods Autoantibodies （ GPⅡbⅢa and GPIb ） against platelet glycoprotein was measured by a monoclonal antibody immobilization of platelet antigen assay （MAIPA） in 40 ITP patients. Results 10 patients had mono-specific antibodies to GP Ⅱ b Ⅲ a and 6 patients had mono-specific antibodies to GPIbα. Another 20 patients had antibodies to both antigens and 4 patients had no detectable antibody to either platelet antigen. There was negative correlation between the antibody against GPⅡbⅢa [ b = - 0.071, P 〈 0.01 ）, GPIbα [ b = 0. 092, P 〈 0.01 ） and platelet counts. The ratio of refractory cases in patients with antibodies to both antigens （ 8/20 ） was significantly higher than that in patients with mono-specific antibodies （ 1/16 ） （ Х^2 = 6.09,P 〈 0.05 ）. Conclusion The specific autoantibodies against platelet might be valuable for discrinination of idiopathic thrombocytopenic purpura and non immune thrombocytopenia. The types of antibodies are related with severity of ITP and therapeutic effect.

关 键 词：血小板减少性紫癜 抗体 血小板糖蛋白 

分 类 号：R554.6[医药卫生—血液循环系统疾病]