成人难治性ITP微小病毒B19与血小板相关抗体及白细胞介素的检测及意义  

Detection of the human parvovirus B19,platelet related antibody,and interleukin in adult refactory idiopathic thrombocytopenic purpura and its significance

作　　者：崔晶[1] 王景文[1] 吴轶苹[1] 翟艳玲[1] 

机构地区：[1]首都医科大学附属北京同仁医院,北京100730

出　　处：《临床血液学杂志》2012年第1期16-18,共3页Journal of Clinical Hematology

摘　　要：目的:探讨微小病毒B19(HPV B19)、血小板相关抗体(PA)和白细胞介素(IL)-2、IL-4在成人难治性血小板减少症(ITP)患者的改变和相关性及其在ITP发病机制中的作用。方法:应用ELISA检测血清中HPVB19-IgG、IgM、PA-IgG、IgM、IgA及IL-2、IL-4水平。结果:①ITP组HPV B19-IgG、IgM阳性数分别为15例、3例,正常对照组分别为3例、0例,2组比较,IgG阳性率差异有统计学意义(P<0.01);IgM型差异无统计学意义(P>0.05)。②对ITP患者根据HPV B19抗体结果分为2组,阳性组15例,PA阳性13例;阴性组7例,PA阳性4例。2组比较差异无统计学意义(P>0.05)。③ITP组IL-2和IL-4水平分别为(47.54±25.74)pg/ml、(34.20±16.79)pg/ml,对照组IL-2和IL-4水平分别为(6.15±1.25)pg/ml、(19.72±4.36)pg/ml,2组比较均差异有统计学意义(均P<0.01)。结论:成人难治性ITP的发病机制复杂,可能与体内细胞因子分泌亢进及HPVB19既往感染有关,这种感染与PA无关;这对于指导临床治疗针对不同的环节具有重要的意义。Objective：To explore the change and correlation of human parvovirus B19 （HPV B19） ,platelet related antibody （PA）, interleukin 2 （IL-2） and interleukin 4 （IL-4） in adult refractory ITP, and study its role in the pathogenesis of refractory ITP. Method：The levels of HPV B19,PA, IL-2,and IL-4 were detected by ELISA. Result：① The positive case numbers of HPV B19-IgG and IgM were 15 and 3 respectively in ITP group,but 3 and 0 respectively in normal controls group. The positive rate of HPV B19-IgG in ITP group was significantly higher than that in control group （P〈0. 01）. But the positive rates of HPV B19 IgM were not statistically different two groups （P^0.05）. ② The patients were divided into two groups according to the results of HPV 1319. The results of PA were 15 positive and 7 negative in HPV B19 positive group, but 7 positive and 4 negative in HPV B19 negative group. There was no statistically significance between two groups （P〉0.05）. ③ The levels of IL-2 and IL-4 were （47.54±25.74）pg/ml and （34.20±16.79） pg/ml respectively in ITP group,but （6.15±1.25）pg/ml and （19.72±4.36） pg/ml respectively in control group （P〈0.01）. Conclusion： The pathogenesis of adult ITP was complex. It involves multiple pathways. It may be related to the hypersecretion of IL-2 or IL-4, and infection of HPV B19. There is no relationship between HPV B19 and PA. It is important for guiding the treatment by aiming at different pathways in ITP.

关 键 词：血小板减少症 微小病毒B19 血小板抗体 白细胞介素-2 白细胞介素-4 

分 类 号：R554[医药卫生—血液循环系统疾病]