免疫性血小板减少症患者血小板COX-1和COX-2的表达及意义  

Expressions and significances of platelet COX-1 and COX-2 in patients with immune thrombocytopenia purpura

作　　者：叶加建 吴定昌[2] 汤忠秀[3] 李丽丽 YE Jia-Jian;WU Ding-Chang;TANG Zhong-Xiu;LI Li-Li(Department of Clinical Laboratory,Fujian Geriatric Hospital,Fuzhou 350003,China)

机构地区：[1]福建省老年医院检验科,福州350003 [2]龙岩市第一医院检验科,龙岩364000 [3]福建省肿瘤医院,福州350000

出　　处：《中国免疫学杂志》2019年第15期1891-1896,共6页Chinese Journal of Immunology

摘　　要：目的:探讨免疫性血小板减少症(ITP)患者血小板环氧化酶-1(COX-1)和环氧化酶-2(COX-2)的表达及意义。方法:选取2015年3月至2017年2月于我院诊治的65例免疫性血小板减少症患者为研究组,另选取同期于我院进行体检的健康献血者61例为对照组。采集两组受试人员的空腹静脉血并进行预处理,采用流式细胞仪检测血小板COX-1、COX-2表达情况,观察并记录患者临床指标包括血小板计数(PLT)、血小板比积(PCT)、平均血小板体积(MPV)、血小板分布宽度(PDW)与血小板相关抗体(PAIgG、PAIgM、PAIgA)及血小板膜糖蛋白(GPⅡb/Ⅲa),并比较其与COX-1、COX-2ITP的相关性。采用受试者工作特征曲线(ROC)分析检测血小板COX-1、COX-2表达对ITP疾病的诊断价值,Logistic多元回归分析影响ITP发生的相关因素。结果:与对照组相比,研究组患者血小板内COX-1、COX-2表达显著升高(P<0.05);相关性分析显示COX-1、COX-2均与MPV、PAIgG、PAIgM、PAIgA呈显著正相关(P<0.05),而均与PLT、PCT、GPⅡb/Ⅲa呈显著负相关(P<0.05);ROC分析结果显示COX-1、COX-2的敏感度分别为69.23%、78.46%,特异度分别为90.62%、84.37%,截断值分别为17.63、23.95;Logistic多元分析结果显示COX-1与COX-2均为免疫性血小板减少症发生的独立危险因素。结论:ITP患者血小板COX-1与COX-2表达均显著高于健康个体,二者呈正相关且均与患者血小板参数密切相关,检测COX-1与COX-2表达对判断ITP患者病情进展及疗效均具有重要的临床意义。Objective: To investigate the expressions and significances of platelet cyclooxygenase-1(COX-1)and cyclooxygenase-2(COX-2) in patients with immune thrombocytopenia purpura(ITP). Methods: 65 cases of immune thrombocytopenia purpura in our hospital from March 2015 to February 2017 were selected as the study group,and 61 healthy blood donors in our hospital were selected as the control group at the same time.The fasting venous blood of the two groups was collected and pretreated,the expressions of COX-1 and COX-2 in platelets was detected by flow cytometry,observe and record patient clinical parameters including platelet count(PLT),platelet specific volume(PCT),mean platelet volume(MPV),platelet distribution width(PDW) and platelet-associated antibodies(PAIgG,PAIgM,PAIgA)and platelet membrane glycoprotein (GPⅡb/Ⅲa) and compare its correlation with COX-1 and COX-2ITP.Receiver operating characteristic curve (ROC) was used to analyze the diagnostic values of platelet COX-1 and COX-2 expressions for ITP disease,Logistic multiple regression analysis was used to analyze the related factors influencing the occurrence of ITP. Results: Compared with the control group,the expressions of COX-1 and COX-2 in platelets increased significantly in the study group( P <0.05).Correlation analysis showed that COX-1 and COX-2 were significantly positively correlated with MPV,PAIgG,PAIgM and PAIgA( P <0.05),but negatively correlated with PLT,PCT and GPⅡb/Ⅲa( P <0.05).ROC analysis showed that the sensitivity of COX-1 and COX-2 was 69.23% and 78.46% respectively,the specificity was 90.62% and 84.37%,respectively,the truncated value was 17.63 and 23.95,respectively.Logistic multiple regression analysis showed that COX-1 and COX-2 were independent risk factors for immune thrombocytopenia purpura. Conclusion: The expressions of COX-1 and COX-2 in platelets of ITP patients was significantly higher than that of healthy individuals,the two are positively correlated and closely related to platelet parameters,detection of COX-1 and COX-2 e

关 键 词：免疫性血小板减少症 环氧化酶-1 环氧化酶-2 

分 类 号：R556.3[医药卫生—血液循环系统疾病]