摘要
目的:探讨特发性血小板减少性紫癜(ITP)与血小板相关抗体之间的相互关系,为临床诊断和治疗提供帮助。方法:回顾性分析了2000年1月～2007年4月应用流式细胞术检测140例临床确诊的ITP患者初诊时及治疗前后不同血小板相关抗体——血小板膜糖蛋白抗体(PAIg)的表达。结果:ITP患者初诊时PAIgG、PAIgA及PAIgM抗体表达水平均高于正常对照组;PAIgG、PAIgM、PAIgA表达水平与血小板数之间均呈负相关,相关系数分别为γ=-0.72、γ=-0.83和γ=-0.67。在确诊ITP后予激素等免疫治疗无效转变为慢性ITP的患者时,PAIgM抗体水平要明显高于激素治疗有效的急性ITP患者,并且PAIgM异常增高或联合PAIgG增高的比例要显著多于急性ITP患者(均P<0.05)。35例PAIgG和PAIgM同时升高的ITP患者,经治疗血小板升至正常后,PAIgG、PAIgM抗体表达水平均有显著下降。结论:ITP的发生与血小板抗体密切相关,初诊ITP患者PAIgM单独或联合PAIgG异常增高常提示预后不良,易转变为慢性ITP。
Objective： To investigate the relationship between PAIg and idiopathic thrombocytopenic purpura （ITP）, thereby improve clinical diagnosis and therapy of patients. Method; We analysed retrospectively 140 patients with ITP who were treated in the First People＇s Hospital of Chang Zhou from January of 2000 to April of 2007, Flow eytometry was used to examine the expressing level of PAIg in newly diagnosised patients with ITP and evaluate the changes before and after treatment. Result; The expressing level of PAIgG, PAIgA and PAIgM were significantly higher in patients with ITP than that in control group, the autoantibodies of all three PAIg classes show highly significant correlations to the platelet counts, double logarithmic negative correlations have been found between PAIgG and platelet count （r= -0.72）, PAIgM and platelet count （r= -0.83）, and PAIgA and platelet count （r= -0.67）. Accordingly, a significant difference in relation of PAIgM to increased expression level and number was found between newly diagnosised patients who were resistant to glucocorticoid treatment and turned to become chronic ITP later and patients with acute ITP who were valid to the glucocorticoid treatment. Conclusion：Taken together, these results suggest a predominant role of PAIg in the pathogenesis of ITP. The high level of PAIgM alone or simultaneously with PAIgG in newly diagnosised ITP may suggest poor prognosis and these patients will turn to chronic ITP.
出处
《临床血液学杂志》
CAS
2007年第6期329-331,共3页
Journal of Clinical Hematology
