HIT抗体检测对下肢动脉硬化性闭塞症患者的临床意义  

The Clinical Research of the Heparin Induced Thrombocytopenia Antibody in Lower Extremity Arteriosclerosis Obliterans(ASO)

作　　者：仝东霞[1] 李吉和[2] 韩碧清[1] 苗美娟[1] 汪辉[1] 

机构地区：[1]哈尔滨医科大学附属二院输血科,黑龙江哈尔滨150086 [2]哈尔滨医科大学附属二院急诊科,黑龙江哈尔滨150086

出　　处：《现代生物医学进展》2012年第30期5920-5922,5881,共4页Progress in Modern Biomedicine

摘　　要：目的:探讨HIT抗体在HIT中的诊断价值。方法:采用酶联免疫吸附法(ELISA)检测HIT抗体,进一步观测应用肝素的患者HIT抗体的产生情况,临床观察血管外科应用普通肝素治疗49名下肢动脉硬化性闭塞症(ASO)患者。采用自身对照,实验组为应用肝素治疗后的49名患者血清,对照组为应用肝素治疗前该49名患者血清,分别进行HIT抗体检测。结果:实验组中HIT抗体阳性例数为21例,对照组为3例。实验组与对照组差异有统计学意义。实验组中9例患者血小板下降(血小板下降范围23.3%～63.8%),其中8例HIT抗体阳性,1例抗体阴性。该9例患者后经功能性检查确诊为HIT患者。其中2例患者血小板下降早于HIT抗体的出现,其余6例患者血小板下降时间比HIT抗体出现时间晚。HIT发病率为18.37%。结论:HIT抗体检测的实验敏感性较高,且不涉及放射性,操作简单,快捷。与临床表现、血小板计数检测结合可对应用肝素的下肢动脉硬化性闭塞症患者进行初筛。Objective： To investigate the diagnose value of HIT antibody in HIT. Methods： HIT antibody was tested by the method of ELISA, to further observe HIT antibody of the patients cxposurcd to heparin. 49 patients of lower limb arteriosclerosis obliterans （ASO） that were therapied by common heparin in blood vessel surgery were observed. The self-comparation method was used to investigate the changes of HIT antibody after heparin treatment. The test group were the patients of ASO that were therapied by common heparin and control group were the same patients before treatment. The HIT antibody was observed in these two groups respectively. Results： There were 21 patients whose HIT antibodies were positive in the test group. There were 3 patients whose HIT antibodies were positive in the control group. In the patient group and control group there were difference by statistics analysis. In patient control group, there were 9 patients＇ platelets reduce （the limit is 23.3%-63.8%）. The HIT antibodies of eight of the nine patients were positive, and the other one was negesitive. The 9 patients were diagnosed HIT by functionality test later. The time of platelet reduce was earlier than the appearing of HIT antibody in two patients and the rest 6 patients were later. The attack rate of HIT is 18.37%. Conclusions： The test of HIT antibody has relatively high sensitivity and distinction. The test can be operated simply, rapidly and with no radiation. Combined with thrombocyte count and clinical manifestation, it can be applied to preliminary screening of arteriosclosis obliterans.

关 键 词：下肢动脉硬化性闭塞症 肝素 血小板减少症 HIT抗体的检测 

分 类 号：R543.5[医药卫生—心血管疾病]