血小板膜糖蛋白抗体在儿童免疫性血小板减少症治疗中的指导意义  

Guiding significance of platelet membrane glycoprotein antibodies in the treatment of pediatric immune thrombocytopenia

作　　者：柴亚玲 李玢[2] CHAI Yaling;LI Bin(Department of Pediatrics,Shenzhen Longhua District People's Hospital,Shenzhen 518000,China;Department of Pediatric Internal Medicine,Shenyang Children's Hospital)

机构地区：[1]深圳市龙华区人民医院儿童医学部,广东深圳518000 [2]沈阳市儿童医院儿内科

出　　处：《沈阳医学院学报》2025年第2期187-190,197,共5页Journal of Shenyang Medical College

摘　　要：目的:探讨血小板膜糖蛋白抗体表达类型与儿童免疫性血小板减少症(immune thrombocytopenia,ITP)治疗效果的相关性。方法:回顾性分析2020年11月至2022年2月于我院接受丙种球蛋白和糖皮质激素治疗的73例ITP患儿的临床资料。比较不同特征及不同抗体表达类型ITP患儿的临床疗效。采用多因素Logistic分析探讨影响ITP患儿疗效的因素。结果:不同年龄、性别和有无前驱感染及出血现象的ITP患儿疗效比较差异无统计学意义(P>0.05);不同抗体表达类型的ITP患儿疗效比较差异有统计学意义(P=0.001)。Logistic回归分析结果显示,抗体双阳性是影响ITP患儿疗效的因素(OR=0.061,95%CI:0.006~0.606,P<0.05)。结论:相较于抗体双阴性,抗体双阳性可明显降低ITP患儿治疗疗效,抗GPⅡb/Ⅲa及GPⅠb/Ⅸ抗体阳性与抗体双阴性疗效相差不多。Objective:To investigate the correlation between the expression types of platelet membrane glycoprotein antibodies and the treatment outcomes in children with immune thrombocytopenia(ITP).Methods:Clinical data of 73 children with ITP who were treated with gamma globulin and glucocorticoid in our hospital from Nov 2020 to Feb 2022 was retrospectively analyzed.The therapeutic efficacy was compared among children with different characteristics and antibody expression types.Multivariable logistic regression analysis was used to analyze the influencing factors of therapeutic efficacy.Results:There was no statistically significant difference in therapeutic efficacy among children with different ages,genders,with or without history of preceding infections,or bleeding manifestations(P>0.05).However,significant differences in efficacy were found among children with different antibody expression types(P=0.001).Logistic regression analysis showed that double-positive antibodies of anti-GPⅡb/Ⅲa antibody and anti-GPⅠb/Ⅳantibody was a factor affecting therapeutic efficacy(OR=0.061,95%CI:0.006-0.606,P<0.05).Conclusion:Compared to double antibody negativity,double antibody positivity can significantly reduce the treatment efficacy in ITP children,and the efficacy of positive anti-GPⅡb/Ⅲa and anti-GPⅠb/Ⅳantibodies is similar to that of double antibody negativity.

关 键 词：免疫性血小板减少症 血小板膜糖蛋白抗体 治疗效果 

分 类 号：R558.2[医药卫生—血液循环系统疾病]