血小板生成素及其抗体与原发性干燥综合征患者血小板减少的相关性研究  

Analysis on the Correlation of Thrombopoietin and Anti-thrombopoietin Antibody with Thrombocytopenia in Patients with Primary Sjogren Syndrome

作　　者：吴侗[1] 周彬[1] 龙丽[1] 张晶[1] 

机构地区：[1]四川省医学科学院.四川省人民医院风湿免疫科,成都610072

出　　处：《华西医学》2016年第5期871-874,共4页West China Medical Journal

基　　金：四川省卫生厅科研基金(120069)~~

摘　　要：目的分析血小板生成素(TPO)及其抗体与原发性干燥综合征(PSS)患者血小板减少的相关性。方法选取2013年9月-2014年10月伴有血小板减少的PSS患者40例(A组)、曾有血小板减少已恢复正常的PSS患者22例(B组)、无血小板减少的PSS患者40例(C组),以及同期正常体检的健康志愿者40例(D组),应用酶联免疫吸附法(ELISA)检测血清TPO水平,间接ELISA法测定抗TPO抗体水平,分析其与临床表现、指标之间的相关性和意义。结果 A组TPO(129.74±17.47)pg/m L,B组TPO(330.23±18.07)pg/m L,C组TPO(364.19±12.25)pg/m L,均高于D组[(54.04±10.71)pg/m L],组间差异有统计学意义(P<0.05);TPO与C反应蛋白、免疫球蛋白A水平呈正相关(rs=0.224,P=0.039;rs=0.239,P=0.033),与补体C4水平呈负相关(rs=-0.220,P=0.041),与血小板计数、红细胞沉降率、抗磷脂抗体水平以抗核抗体滴度无相关性(P>0.05)。PSS患者抗TPO抗体阳性率为20.59%(21/102),A、B、C组分别为17.5%(7/40)、22.7%(5/22)、22.5%(9/40),组间差异无统计学意义(P>0.05),抗TPO抗体阳性组与阴性组组间各临床指标差异无统计学意义(P>0.05)。结论抗TPO抗体可能不是PSS血小板减少的主要发病机制,TPO与炎症因子有一定相关性。Objective To analyze the correlation of thrombopoietin（TPO） and anti-TPO antibody with thrombocytopenia in patients with primary Sjogren syndrome（PSS）.Methods We included in our study 40 PSS patients with thrombocytopenia（group A）,22 PSS patients who once had thrombocytopenia and returned to normal（group B）,40 PSS patients with normal platelet counts（group C） and 40 healthy controls（group D） between September2013 and October 2014.Anti-TPO antibody was detected by indirect enzyme-linked immunosorbent assay（ELISA）,and serum TPO levels were measured by ELISA.We analyzed the relationship between the assay results and the clinical manifestations and parameters.Results The serum TPO levels in groups A,B,and C were（129.74±17.47）,（330.23±18.07）and（364.19±12.25） pg/mL,respectively,and they were significantly higher than that in group D[（54.04±10.71） pg/mL]（P〈0.05）.The serum level of TPO was positively correlated with CRP and IgA（rs=0.224,P=0.039;rs=0.239,P=0.033）,and was negatively correlated with C4 level（rs=-0.220,P=0.041）,but it was not significantly correlated with platelet count,erythrocyte sedimentation rate,the level of antiphospholipid antibodies and the titer of antinuclear antibodies（P〉0.05）.The positive rate of PSS patients was 20.59%（21/102） and the rate in groups A,B,and C was respectively 17.5%（7/40）,22.72%（5/22）,and 22.5%（9/40）.There was no statistically significant difference between the positive and negative groups in various clinical indexes（P〉0.05）.Conclusion AntiTPO antibody may not be the main mechanism of thrombocytopenia in PSS patients,and there is a certain correlation between TPO and inflammatory factors.

关 键 词：原发性干燥综合征 血小板减少 血小板生成素 抗血小板生成素抗体 

分 类 号：R593.2[医药卫生—内科学]