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1.
流式细胞术检测血小板相关IgG的临床应用   总被引:3,自引:0,他引:3  
目的:研究流式细胞式(FCM)检测血小板相关免疫球蛋白G(PAIgG)的特点及在特发性血小板减少性紫癜(ITP)诊断中的意义。方法:用FCM检测了47例ITP、13例非免疫性血小板减少、10例自身免疫溶血性贫血、18例其它免疫系统疾病患者以及31例健康志愿者的PAIgG,并与ELISA竞争法检测结果比较。结果:FCM检测ITP患者PAIgG的平均荧光强度和阳性血小板百分率均明显高于正常对照组(P〈0.01),11例有峰形异常。ITP患者FCM检测的阳性率(87.2%)比ELISA法(83.0%)稍高,两种方法的符合率为85.1%。但两种方法都存在特异性不高的问题。结论:FCM检测PAIgG具有快速、简便和灵敏等特点,可作为免疫性血小板减少实验诊断的新方法。  相似文献   

2.
巨细胞病毒感染与动脉粥样硬化的临床研究   总被引:7,自引:0,他引:7  
目的探讨人类巨细胞病毒(HCMV)感染、肿瘤坏死因子(TNF)及血浆内皮素(ET)浓度与动脉粥样硬化的关系。方法采用间接免疫荧光技术测定急性心肌梗塞组(20例)、冠状动脉狭窄组(20例)及正常对照组(30例)血清人类巨细胞病毒抗体,用放射免疫法测定血清TNF及ET的浓度。结果急性心肌梗塞组HCMVIgM阳性14例(70%),HCMVIgG阳性20例(100%),HCMVIgM、IgG双阳性14例(70%);冠状动脉狭窄组HCMVIgM阳性19例(95%),HCMVIgG阳性19例(95%),IgM、IgG双阳性18例(90%);正常对照组HCMVIgM阳性6例(20%),HCMVIgG阳性26例(82%),IgM、IgG双阳性6例(20%),与正常对照组比较,差异有显著性(P<0001,P<005,P<0001);冠心病急性心肌梗塞组、冠状动脉狭窄组与正常对照组相比,血清TNF、血浆ET显著增高(P<0001)。结论患者的HCMV感染、内皮细胞受损和TNF作用可能参与了冠心病发生发展的过程。  相似文献   

3.
不同病型,病期HFRS患者特异性抗体水平测定及其临床意义   总被引:1,自引:0,他引:1  
用捕获ELISA方法检测了60例(120份)肾综合征出血热患者(HFRS)血清特异性IgA、Ig-E、IgM、IgG抗体。发现4种抗体几何平均滴度均随病期进展逐渐升高,且早期(发热及休克少尿期)与后期(多尿恢复期)间有差异性。HFRS-IgM、IgE、IgG抗体水平的差异在早期(特别是发热期)尤为显著(P<0.05)。结果显示,HFRS-IgM确属早期较可靠诊断指标;HFRS-IgG、IgE抗体水平与病情严重度相关。HFRS-IgA抗体可能是一种保护性抗体。  相似文献   

4.
日本血吸虫31/32kDa循环免疫复合物的检测及其在疾病 …   总被引:2,自引:0,他引:2  
检测血吸虫循环免疫复合物(CIC)有助于提高疾病的检出率。利用抗血吸虫单克隆抗体H226和碱性磷酸酶标记的羊抗人IgG(Fc)作捕捉ELISA,检测E要血吸虫病患者血清CIC,其阳性检出率为92.2%,其中,EPG〈100的病人阳性检出主继90.0%,EPG〉100的病人阳性检出率为95.5%,两者无显著性差异。由于羊抗人IgG Fc段能与CIC中人IgG的Fc段特异性结合,因此不驻省去了常规分离  相似文献   

5.
应用5种不同方法测定了6例弓形虫病人不同病期的血清标木。用IHAT和IFAT测定抗弓形虫总免疫球蛋白,IHAT在发病后第3周的2份血清标本中有1份已呈阳性,14~17周达高峰。滴度升高非常明显;IFAT第3周的标本都呈阳性,17~24周达高峰。用IgG-ELISA和IgM-ELISA,IgM-IFAT分别测定抗弓形虫特异性抗体IgG和IgM,IgG-ELISA从第6周呈阳性,随病情延长,滴度明显升高;IgM-ELISA两份第3周的标本都呈阳性,至少第17周仍保持较高水平,其中1人第24周的标本仍呈阳性;但IgM-IFAT仅2例(2/6)呈阳性且滴度不很高,在较短时间内就转阴。结果表明:病人的抗体类型相似;IgG-ELISA,IgM-ELISA和IFAT敏感特异,IHAT简便、快速;高滴度特异性IgG易掩盖IgM-IFAT;IgM-ELISA可为早期诊断提供依据。  相似文献   

6.
检测了43例原发性血小板减少性紫癜(ITP)患者血浆中蛋白C(PC)活性和50例正常人PC活性,前者为79.8±23.4%;后者94.4±13.2%。ITP患者血浆PC抗凝活性显著低于正常对照组(P<0.01)。分析了ITP患者的PC活性与血小板数量、功能,血小板表面相关IgG(PAIgG),血浆纤维结合蛋白(Fn)之间无相关关系。  相似文献   

7.
目的:为了指导风湿热的防治并改善其预后,寻找特异性和敏感性较高的指标以探讨风湿热活动性。方法:采用最具生物活性的A组链球菌壁多糖部分作包被抗原,以ELISA法测定抗链球菌壁多糖抗体(ASP)IgG、IgM。结果:风湿性心脏病活动期ASPIgG、IgM的水平(3652±2195和2619±0748)和阳性率(561%和756%)显著高于正常人、风湿性关节炎和风湿性心脏病静止期(P<005~00001),后二者ASP-IgG、IgM的水平和阳性率明显高于正常人(P<005~001);随治疗ASP-IgM下降较快(P<0001),ASP-IgM与反映风湿热活动的传统指标(血沉、C-反应蛋白等)之间具有正相关性,ASP在风湿热活动中的阳性率(854%)明显高于ESR、CRP和ACL。结论:ASP在判断风湿热活动性方面具有较高的敏感性  相似文献   

8.
应用酶联免疫吸附试验(ELISA)对无选择性作内镜检查的90例患者血清,分别作抗HPIgG,IgA,IgM特异性抗体的检测,同时与胃粘膜活检组织块的镜检,培养,快速尿素酶试验的结果进行比较。ELISA检测结果显示血清IgG,IgA,IgM抗体的阳性率分虽为71.1%(64/90),56.6%(51/90),56.6%(51/90),IgG检出率均高于检法65.6%%(59/90),尿素酶试验55.  相似文献   

9.
赵瑞  周悌 《地方病通报》1998,13(3):37-39
应用ABC-ELISA、SPA-ELISA和细胞学检查41例脑囊虫病患脑脊液抗囊虫抗体及细胞学异常进行对比观察分析。结果显示,ABC-ELISA法阳性37例(90.2%),SPA-ELISA法阳性34例(80.5%),细胞学异常29例(70.7%)。37例脑脊液抗囊虫抗体阳性嗜酸性粒细胞、激活淋巴细胞、浆细胞、嗜碱性粒细胞的检出率分别为78.3%、73.0%、75.7%和24.3%;抗体滴  相似文献   

10.
骨关节炎患者血清抗软骨细胞抗体测定及其意义   总被引:2,自引:0,他引:2  
目的:为了探讨抗软骨细胞自身免疫反应在骨关节炎(OA)发病中的可能作用。方法:用培养的人软骨细胞制备抗原,采用酶联免疫法(ELISA)检测41例OA患者血清抗软骨细胞抗体(ACA)水平,并与29例类风湿关节炎患者(RA),33例其它关节炎或关节痛患者及20名正常人对照。结果:OA和RA患者血清IgGACA和IgMACA水平均显著高于其它关节炎或关节痛患者和正常人组(P<001)。ACA阳性率在OA组为439%,低于RA组的827%(P<0001),高于其它关节炎或关节痛患者的182%和正常人组的50%(P>005);有膝关节积液者在ACA阳性OA患者占556%,在ACA阴性OA患者仅为174%(P<001)。结论:针对软骨细胞的自身免疫反应可能参与OA的病理过程;OA滑膜炎的发生可能与ACA诱发的免疫反应有关。  相似文献   

11.
BACKGROUND AND OBJECTIVES: Despite an extensive search for a definitive diagnostic assay for platelet autoantibodies, the laboratory diagnosis of immune thrombocytopenia (ITP) still remains a clinical challenge. Data in the literature have so far demonstrated that measurement of platelet-associated IgG (PAIgG) is sensitive, especially when flow cytometry is employed, but lacks adequate specificity. Measuring specific autoantibodies by antigen capture techniques increases specificity, but a large part of patients escape autoantibodies detection by such means too. The aim of the present study was to compare the diagnostic value of PAIgG with a modified antigen capture ELISA (MACE) in patients with primary and secondary immune thrombocytopenia and in patients with non-immune thrombocytopenia. DESIGN AND METHODS: One hundred and four patients with a platelet count lower than 100x109/L were studied. Forty-two patients had primary ITP (P-ITP), 23 patients had ITP secondary to other immune diseases (S-ITP) and 39 patients had thrombocytopenia due to decreased platelet production (non-immune; NITP). PAIgG was measured by immunofluorescent flow cytometry, whereas specific platelet-associated autoantibodies (against GP IIb/IIIa, Ib/IX, Ia/Ia) were measured by a commercially available modified antigen capture assay (MACE, GTI, USA). RESULTS: The sensitivity of the PAIgG assay for ITP was 60%, the specificity was 77%, the positive predictive value was 81% and the negative predictive value was 54%. The sensitivity of MACE was 60%, specificity was 97%, the positive predictive value 97% and the negative predictive value 59%. We found a 73% concordance between PAIgG and MACE assays. Both PAIgG and MACE had significantly greater sensitivity in S-ITP than in P-ITP. INTERPRETATION AND CONCLUSIONS: Forty percent of patients with clinically diagnosed immune thrombocytopenia had no detectable platelet autoantibodies, possibly because of intrinsic methodological detection problems, different stages of disease, or absence of a true immune etiology.  相似文献   

12.
应用ELISA法对 41例慢性特发性血小板减少性紫癜 (ITP)患者和 2 5例健康对照者进行血浆和 (或 )血清血小板相关抗体 (PAIgG)、抗心磷脂抗体 (ACAIgG)测定 ,并常规血小板计数。发现ITP患者治疗有效组治疗后血小板计数明显升高、PAIgG含量显著降低 ,治疗前较治疗后及对照组均有显著性差异 (P <0 .0 1 ) ,且血小板计数与PAIgG之间呈显著性负相关 (r =- 0 .738,P <0 .0 0 1 )。而治疗无效组血小板计数、PAIgG均无明显变化。ACAIgG治疗前后无明显变化 ,且未发现与血小板及PAIgG相关。PAIgG、ACAIgG含量增高提示ITP患者针对血小板磷脂及其他糖类蛋白等不同抗原产生了自身免疫反应 ,为免疫抑制剂的应用提供了理论依据  相似文献   

13.
Kelton  JG; Steeves  K 《Blood》1983,62(4):924-927
The biologic relevance of the increased platelet-associated IgG (PAIgG) on platelets from patients with idiopathic thrombocytopenic purpura (ITP) is unclear. Platelets from ITP patients are often larger than normal, and it is possible that the increased IgG is not specific but passively related to platelet size. The measurement of platelet-bound albumin could provide information concerning the specificity of the platelet-bound IgG, since albumin, like IgG, is a plasma protein, but unlike IgG, is not an active participant in immunologic reactions. Albumin is also a normal constituent of platelet membrane, and increased platelet albumin could indicate an increased platelet mass. Platelet-bound albumin, IgG, and total platelet protein were measured on both intact and disrupted platelets from healthy individuals (n = 25) and patients with ITP (n = 21). Platelet IgG and albumin were measured in an immunoradiometric assay using intact antisera and F(ab')2 fragments prepared from the same antisera. There was no relationship between platelet-bound IgG or albumin, and platelet size measured by either platelet protein or platelet volume, (r less than 0.3 for all interactions). In contrast, there was a significant correlation between platelet-bound albumin and platelet-bound IgG (r = 0.7, n = 21, p less than 0.001). Those patients with elevated platelet PAIgG also had elevated platelet albumin, and this relationship was irrespective of the total platelet protein content or mean platelet volume. It is possible that the increased platelet-bound IgG in ITP reflects an increase in platelet surface area or contaminating platelet fragments that are not manifested as an increase in platelet volume or total platelet protein. Alternatively, a platelet membrane abnormality may occur in ITP that results in the uptake of significant amounts of plasma proteins. Either possibility implies that not all of the IgG on platelets from patients with ITP is pathologic IgG.  相似文献   

14.
Platelet-associated Ig classes and IgG subclasses were studied by a semiquantitative platelet ELISA test in 17 children with immune thrombocytopenic purpura (ITP). An elevation of PAIg was found in 94% of the children. In nearly all cases increased amounts of PAIgG of subclass G1 was seen, and in half of the cases increased amounts of PAIgM were also seen. No statistical difference in the composition of PAIg classes and PAIgG subclasses in acute and in chronic ITP was found. However, a correlation of increased amount of PAIgG3 and very low platelet count (20 x 10(9)/l) was observed.  相似文献   

15.
S ummary . Platelet-associated IgG (PAIgG), platelet mean life span (MLS), and platelet sequestration sites were studied in 69 patients with immune (ITP) and presumed nonimmune thrombocytopenias (NTP). A shortened MLS was associated with elevated PAIgG (N=46), and with normal PAIgG (N=15), Four patients had a normal MLS, but elevated PAIgG, four patients were normal for both parameters. The highest PAIgG values occurred in ITP patients with a very short MLS. Nine NTP patients had also elevated PAIgG, but a normal or slightly shortened MLS. There was a significant double log correlation between PAIgG and MLS for ITP, but not for NTP patients. Judged from the coefficient of determination, only 10% of PAIgG were directly related to a shortened MLS.
70% of patients (N= 63) had exclusively splenic and 30% hepatosplenic sequestration. PAIgG was elevated in 29/44 patients with splenic (66%) and in 16/19 patients with hepatosplenic sequestration (84%). In ITP, PAIgG-positive cases were observed in 69% of splenic v 82% of hepatosplenic sequestration, while in NTP the corresponding figures were 6/11 and 2/2. No significant correlation between PAIgG and either sequestration type was demonstrable.
We conclude that in immunologically mediated thrombocytopenia only a small portion of PAIgG accounts for a decreased MLS, and that the concentration of PAIgG per se does not determine the platelet sequestration type.  相似文献   

16.
Serum leptin levels in patients with idiopathic thrombocytopenic purpura   总被引:2,自引:0,他引:2  
OBJECTIVES: The purpose of this study was to evaluate serum leptin levels in idiopathic thrombocytopenic purpura (ITP), in order to determine the influence of leptin on the pathogenesis of ITP. SUBJECTS AND METHODS: Forty-six untreated patients with chronic ITP were compared with 40 healthy people of similar age, sex and body mass index (BMI). Serum leptin levels (ng/mL) were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS: We found that the mean serum leptin levels in patients with ITP (22.11 +/- 15.84 ng/mL) were significantly (P < 0.001) higher than that in healthy control volunteers (5.44 +/- 4.84 ng/mL). Furthermore, serum leptin levels in patients with ITP were inversely related (r = -0.86, P < 0.001) to the platelet counts and positively related to the platelet-associated IgG (PAIgG) levels (r = 0.7, P < 0.001). The levels of PAIgG and platelet counts were significantly different between leptin-positive (level greater than mean +/- 2 SD control value) and leptin-negative patients. CONCLUSION: These findings suggest that leptin might play an important role in the pathogenesis of ITP.  相似文献   

17.
用流式细胞术直接免疫法检测l72例早期特发性血小板减少性紫癜(ITP)患者外周血淋巴细胞亚群(CD3、CD4、CD8、CD19、C16、CD56),ELISA法检测血小板表面血小板相关抗体(PAIgG、PAIgA、PAIgM)。结果显示,ITP组与正常对照组比较CD3、CD4/CD8显著降低(P<0.01),CD8增高(P<0.05),CD19增高极为显著(P<0.01);ITP血小板表面PAIgG、PAIgA、PAIgM显著高于对照组;CD19升高和CD4/CD8下降与PAIgG、PAIgA、PAIgM增高有显著的相关性。认为淋巴细胞亚群功能和比例失常、T细胞免疫调节机制紊乱在ITP的发病机制中起非常重要的作用。  相似文献   

18.
Platelet-associated IgG (PAIgG) can be measured on intact platelets or following platelet lysis. Measurement of PAIgG following platelet lysis may provide different or additional information compared to PAIgG measured on intact platelets. The PAIgG of lysed platelets represents "total" PAIgG, ie, IgG on the surface of platelets plus any IgG that was inside the platelet. To investigate the clinical relevance of the two types of PAIgG assay we performed a prospective study on washed platelets collected from 47 patients with idiopathic thrombocytopenic purpura (ITP). The PAIgG was measured on intact and lysed platelets using an immunoradiometric assay. Platelet-associated IgG was 2-3 times higher when measured on lysed platelets from healthy controls or patients with ITP compared to PAIgG measured on the same intact platelets. The higher level of PAIgG observed following platelet lysis was not due to the reactions not achieving equilibrium. Using lysed platelets, PAIgG was elevated on 29 of 47 samples from different ITP patients and elevated in 31 samples when measured on intact platelets. The PAIgG is invariably higher when measured following platelet lysis compared measurements made on intact platelets. Neither technique offers a diagnostic advantage over the other.  相似文献   

19.
Platelet-associated IgG in immune thrombocytopenic purpura   总被引:8,自引:0,他引:8  
A method for the measurement of immunoglobulin G associated with gel- filtered platelets is described and finding in 70 control subjects and 37 patients with immune thrombocytopenic purpura (ITP) are reported. Control platelet-associated IgG (PAIgG) levels (nanograms IgG per 10(9) platelets) averaged (+/-SD) 1231+/-424; samples studied after 24 and 48 hr remained within the control range. PAIgG values of 19 adult and 12 childhood patients with chronic ITP averaged 4711+/-3025 and 4923+/- 3955, respectively, and differed significantly from controls (p less than 0.001). There was an inverse correlation between PAIgG values and the chronic ITP patient's platelet count. Six patients with childhood acute ITP had PAIgG levels ranging from 5588 to 56,250 and appeared to represent a different statistical population from those with chronic ITP. In chronic ITP patients responding to splenectomy, there was an immediate normalization of PAIgG levels; however, a certain percentage of patients studied several months after splenectomy evidenced elevated PAIgG levels in association with normal platelet counts. These data showed that the direct measurement of platelet associated antibody is a useful technique in the diagnosis and follow-up of patients with chronic ITP. Preliminary studies in patients with acute ITP have suggested that this method may be useful in differentiating acute and chronic childhood ITP.  相似文献   

20.
Quantitation of platelet-associated IgG by radial immunodiffusion   总被引:1,自引:0,他引:1  
Morse  BS; Giuliani  D; Nussbaum  M 《Blood》1981,57(4):809-811
Platelet-associated IgG (PAIgG) was measured by a simple radial immunodiffusion technique using washed solubilized platelets and commercially available immunoplates. Subjects with normal platelet counts had PAIgG levels of 1.5--7.0 fg/platelet. Subjects with idiopathic immune thrombocytopenic purpura (ITP) had levels ranging from 5.7 to 70.5 fg/platelet. All patients with recurrent ITP and 85% of patients with acute ITP had elevated PAIgg. Elevated PAIgG was also found in 17% of patients with recovered ITP, 40% of patients with SLE and thrombocytopenia, 57% of patients with thrombocytopenia occurring during the course of septicemia, and 100% of patients with IgG myeloma in whom the serum IgG level was clearly elevated, regardless of the platelet count. The results are similar to reports that used more complex techniques.  相似文献   

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