抗血小板生成素抗体与系统性红斑狼疮伴血小板减少的相关性研究  

Anti-thrombopoietin antibodies in systemic lupus erythematosus with thrombocytopenia

作　　者：吴晓丹[1] 罗雄燕[2] 陈龙[2] 张晶[1] 吴侗[1] 杨明辉[2] 周彬[1] 

机构地区：[1]四川省成都医学科学院四川省人民医院风湿免疫科,四川省成都610072 [2]川北医学院附属医院风湿免疫研究所

出　　处：《中华风湿病学杂志》2012年第11期745-748,共4页Chinese Journal of Rheumatology

基　　金：四川省卫生厅课题（110141）

摘　　要：目的分析抗血小板生成素（TPO）抗体在系统性红斑狼疮（SEE）中的作用，并探讨其与SLE伴血小板减少及病情的相关性。方法应用酶联免疫吸附试验（ELISA）检测56例SLE患者中的抗TPO抗体，并与20例免疫性血小板减少性紫癜（ITP）及20名健康人对照。同时分析SLE患者临床特点。正态分布的计数资料采用r检验或Fisher精确检验，计量资料采用t检验，非正态分布采用M（p）表示及Wilcoxon’srank检验。结果抗TPO抗体在SLE组中阳性率为39％，35％的免疫性血小板减少患者抗TPO抗体阳性，而健康对照中未能检测到抗TPO抗体（X^2=11．058，P=0．001）。26例伴发血小板减少的SLE患者中，15例（58％）抗TPO抗体阳性，而30例元血小板减少患者中仅有7例（23％，X^2=6．894，P=O．009）；进一步分析发现抗TPO体抗体阳性患者其血小板下降程度重（t=3．010，P=0．004）。对照抗TPO抗体阳性与阴性患者的临床资料显示，关节炎坼=5．959，P=0．015）、抗双链DNA（dsDNA）抗体阳性（X^2=5．959，P=0．015）的SLE患者更易产生抗TPO抗体。结论在伴发血小板减少的SLE患者中检测出较高阳性率的抗TPO抗体表明该抗体可能在SLE发生血小板减少的过程中起重要作用。在伴发血小板减少的SLE患者中检测该抗体具有一定的临床价值。Objective To investigate the existence and significance of circulating autoantibodies to thrombopoietin （TPO） in sera from patients with systemic lupus erythematosus （SLE）. Methods Fifty-six consecutive patients with SLE, twenty patients with idiopathic thrombocytopenic purpura （ITP）, and twenty normal individuals were involved in this study. The characteristics of all patients with SLE were analyzed. Antibodies to TPO were detected using an enzyme-linked immunosorbent assay （ELISA）. For normal distribution count data,X^2 test or Fisher exact test was used, t test was used for measurement data, and Wileoxon＇s rank test for non-normally distributed data which was represented by M（Q）. Results A higher frequency of antibodies to TPO were observed in SLE patients than those in healthy controls （39.3% vs 0, X^2=11.058, P=0.001）. Moreover, anti-TPO antibodies were detected in 15（57.7%） of 26 SLE patients with thrombocytopenia, compared with that in 7 （23.3%,）（2=6.894, P=0.009） of 30 patients without thrombocytopenia. Furthermore, the patients with antibodies to TPO exhibited more severe thrombocytopenia （t=3.010, P- 0.004）. Finally, anti-TPO antibodies seemed more likely to occur in patients with arthritis X^2=5.959, P= 0.015）, anti-dsDNA antibodies X^2=5.959, P=0.015）. Conclusion The high incidence of antibodies to TPO in SLE patients with thrombocytopenia suggests that anti-TPO antibodies might play a vital role in SLE patients developing thromboeytopenia. Thus, there might be a clinical value by detecting anti-TPO antibodies in SLE patients with thromboeytopenia.

关 键 词：红斑狼疮 系统性 血小板减少 抗血小板生成素抗体 

分 类 号：R593.241[医药卫生—内科学]