免疫性血小板减少症时检测血小板相关抗体及血小板膜糖蛋白的意义  

Significance of Detecting Platelet Associated Antibody and Platelet Membrane Glycoprotein for Diagnosis of Immunne Thrombocytopenia

作　　者：邵剑峰[1] 詹乾钢[1] 刘忠民[1] 钟永根[1] 管允理[1] 付佳萍[1] 封蔚莹[1] 楼大钧[1] 

机构地区：[1]浙江省绍兴市人民医院,绍兴312000

出　　处：《中国实验血液学杂志》2004年第2期224-227,共4页Journal of Experimental Hematology

摘　　要：为探讨血小板表面血小板相关抗体 (血小板相关免疫球蛋白 )及血小板膜糖蛋白在免疫性血小板减少症中的诊断及预后评价方面的应用价值 ,采用流式细胞术 (FCM)测定了 76例血小板减少症患者及 30名正常人血小板表面血小板相关免疫球蛋白 (PAIg)及血小板膜糖蛋白 (CD4 1,CD6 1,GPIIb/IIIa)。结果发现 ,初治 38例特发性血小板减少性紫癜 (ITP)患者中血小板相关抗体 (PAIgG、PAIgM、PAIgA)在血小板表面阳性百分率均高于正常对照组 (P <0 .0 0 1) ,血小板膜糖蛋白均低于正常对照组 (P <0 .0 1) ;9例经激素治疗的ITP患者PAIgG ,PAIgM ,PAIgA与正常对照组相比差异无统计学意义 (P >0 .0 5 ) ,血小板膜糖蛋白与正常对照组相比差异无统计学意义(P >0 .0 2 ) ;继发性血小板减少症患者 (慢性再生障碍性贫血、白血病、SLE、Evans综合征、甲亢、乙肝后肝硬化脾功能亢进 )血小板相关抗体在血小板表面阳性百分率均高于正常对照组 (P <0 .0 0 1) ,血小板膜糖蛋白均低于正常对照组 (P <0 .0 5 ) ;12例治疗有效患者治疗后血小板相关抗体较治疗前下降 (P <0 .0 5 ) ,血小板膜糖蛋白上升 ,其差异有统计学意义 (P <0 .0 1)。结论 :FCM用于免疫性血小板减少症患者的血小板相关抗体及血小板膜糖蛋白检测 ,具有灵敏、快速、简便的?The aim of this study was to explore application value of detecting platelet associated antibody and platelet membrane glycoporotein in the diagnosis and prognosis for immune thrombocytopenia. The platelet associated immunoglobulin (PAIg) and platelet membrane glycoprotein (CD41, CD61, GPⅡb/Ⅲa) in 76 cases of immune thrombocytopenia and 30 healthy subjects were detemined by FCM. The results showed that PAIg level in ITP patients included PAIgG (31.25 ±18.06)%, PAIgM (32.41±15.51)%, PAIgA (23 39±16.67)% which were remarkedly higher than in health control (10.48±5.05)%, (9.40±4.42)% and (7 23±3.61)% (P<0.001). In patients with secondary immune thrombocytopenia (chronic aplastic anemia, SLE, Evans syndrome, liver cirrhosis hypersplenism, etc), PAIg level was higher than that in control group, while the platelet membrane glycoprotein in the blood of these patients was lower than that in control group. The level of PAIg decreased (P<0.05) after treatment, but platelet membrane glycoprotein increased (P<0.01). The result suggested that measurements for platelet membrane glycoprotein and platelet associated antibody by FCM were practical with high sensitivity, rapidity and simplicity used as a routine method in diagnosis and evaluation of the therapeutic effects in immune thrombocytopenia patients.

关 键 词：免疫性血小板减少症 血小板相关抗体 血小板膜糖蛋白 

分 类 号：R558.2[医药卫生—血液循环系统疾病]