一种新的血小板特异性抗体检测方法对免疫性血小板减少症诊断价值的研究  

A novel diagnostic measure of platelet-specific antibody in immune thrombocytopenia

作　　者：周雪丽 阎石 李强[1] 李鹏[1] 周泽平 杨仁池 

机构地区：[1]中国医学科学院、北京协和医学院血液学研究所、血液病医院,天津300020

出　　处：《中华血液学杂志》2012年第3期200-203,共4页Chinese Journal of Hematology

基　　金：国家自然科学基金（81070397）;天津市自然科学基金（09JCYBJC10900、10JCZDJC19700）部分资助

摘　　要：目的检测血小板减少患者血清中针对血小板糖蛋白的特异性抗体，评价其对免疫性血小板减少症的诊断价值。方法采用商业化试剂盒PAKAUTO，用酶联免疫吸附法（ELISA）检测各种血小板减少患者的自身血小板抗GPⅡb／Ⅲa、GPIb／Ⅸ、GPIa／Ⅱa特异性抗体。结果在免疫性血小板减少症诊断中此方法敏感性为44．0％，特异性为95．7％，阳性预测值为98．0％，阴性预测值为26．2％。阳性患者中GPⅡb／Ⅲa抗体阳性率为87％，GPIa／，Ⅱa抗体阳性率为35％，GPIb／Ⅸ抗体阳性率为10％。检测时未用免疫抑制剂患者阳性率（58．5％）高于用药患者（26．9％），差异有统计学意义（P〈0．01）；PLT≤×10^9／L患者阳性率（51．6％）高于PLT〉20×10^9／L患者（27．8％），差异有统计学意义（P〈0．01）；继发免疫性血小板减少症患者阳性率（66．7％）高于原发免疫性血小板减少症患者（41．7％），差异有统计学意义（P〈0．05）。结论PAKAUTO检测特异性强，可有效区分免疫性和非免疫性血小板减少，在免疫性血小板减少症临床诊断中可推广应用。Objective To detect the platelet glycoprotein-specific antibodies in serum of thrombocytopenia patients and evaluate its diagnostic value for immune thrombocytopenia. Method Anti-GP Ⅱb/m a, GP Ⅰ b/Ⅸ and GP Ⅰa/1/a antibodies were assayed by ELISA kit （PAKUTO） in patients with thrombocytopenia. Results The sensitivity and specificity of PAKAUTO in immune thrombocytopenia were 44.0% and 95.7%, respectively. The values of positive and negative predictions were 98.0% and 26.2% , respectively. Among those PAKAUTO positive patients, positive rates of GP Ⅱb/m a, GP Ⅰ b/Ⅸ and GP I b/IX were 87%, 35% and 10%, respectively. The positive rate of patients not received immunune suppressive agents （58.5%） was significantly higher than those received immunune suppressive agents （26.9%） （P 〈 0. 0l ）. The positive rate of patients with platelet count ≤20 ×10^9/L （51.6%） was significantly higher than those with platelet count 〉 20 ×10^9/L（27.8% ） （P 〈 0.01 ）. The positive rate of patients with secondary immune thrombocytopenia （66. 7% ） was significantly higher than those with primary immune thrombocytopenia （41.7%） （P 〈 0.05）. Conclusion The highly specific method （PAKAUTO） could effectively differentiate immune or non-immune thrombocytopenia and be applied to diagnosis of immune thrombocytopenia.

关 键 词：酶联免疫吸附试验 血小板减少症 免疫性 诊断 

分 类 号：R558[医药卫生—血液循环系统疾病]