血小板膜表面脱糖效应与免疫性血小板减少症一线治疗疗效关系的研究  

Correlation of the Desialylation of Platelets with Efficacy of the First-line Therapy for ITP

作　　者：陶莉莉[1] 汪嘉佳 潘莹[1] 王会平[1] 陶千山[1] 曾庆曙[2] 倪合宇[3] 翟志敏[1] 

机构地区：[1]安徽医科大学第二附属医院血液内科(安徽医科大学血液病研究中心),安徽合肥230601 [2]安徽医科大学第一附属医院血液内科,安徽合肥230022 [3]加拿大多伦多大学实验医学与病理生物学系

出　　处：《中国实验血液学杂志》2015年第2期460-464,共5页Journal of Experimental Hematology

摘　　要：目的:检测免疫性血小板减少症(ITP)患者血小板脱糖标记物——鸡冠刺桐凝集素(ECL)、蓖麻凝集素(RCA-1)的结合水平,并与ITP一线治疗疗效进行相关性比较。方法:运用多参数流式细胞术在室温条件下检测48例ITP患者治疗前血小板脱糖水平(ECL、RCA-1)。结果:糖皮质激素和(或)静脉免疫球蛋白(IVIG)一线治疗疗效不同的各组ITP患者血小板脱糖水平的差异有显著统计学意义(P<0.05);疗效与脱糖的相关性分析提示二者呈负相关(P<0.01),即脱糖水平越高,一线治疗疗效越差。结论:ITP患者的血小板脱糖程度与一线治疗疗效相关,脱糖越显著的患者疗效越差,这间接提示了ITP患者血小板清除存在非FcR依赖途径,血小板脱糖水平可以在一定程度上提示ITP患者的一线治疗效果,为难治性ITP寻找新的治疗靶点提供理论依据。Objective： To detect desialylation of platelets in primary immune thrombocytopenia （ITP） patients with FITC-labelled ECL and RCA-1, and compare the correlation of the desialylation level and the efficacy of first-line therapy for ITP. Methods： Before treatment, 48 ITP patients were selected and their levels of ECL and RCA-1 were detected with flow cytometry. Results： The desialylation level in the different efficacy groups by using the first-line therapy of corticosteroids and （or） intravenous imrnunoglobulin G （IVIG） had a statistically significant difference（ P 〈 0.05 ）. The correlation analysis showed negative relation of the therapeutic efficacy with desialylation level, that is to say, the more high of desialylation level, the more poor therapeutic efficacy of the first-line therapy. Conclusion： The desialylation level of platelets in ITP patients is related with the first-line therapeutic efficacy, the efficacy for patients with high desialylation level is poor, suggesting that the FcR-independent pathway exists in clearance of platelets in ITP patients. Therefore, the desialylation level of platelets may suggest the first-line therapeutic efficacy for ITP patients to a certain degree, and may be used as a potential target for the treatment of refractory ITP.

关 键 词：免疫性血小板减少症 血小板 脱糖效应 一线治疗 

分 类 号：R558.2[医药卫生—血液循环系统疾病]