血小板特异性抗体对特发性血小板减少性紫癜诊断价值的研究

本研究的目的是比较特发性血小板减少性紫癜 (ITP)、慢性再生障碍性贫血 (CAA)、恶性血液病患者及健康志愿者特异性抗体水平 ,以评价血小板特异性抗体在ITP诊断中的价值。用改良单克隆抗体特异性俘获血小板抗原 (MAIPA)技术同时检测血小板GPIb/Ⅸ、GPIIb/Ⅲa、GPⅣ、GPⅤ的特异性抗体。结果表明 :ITP组、CAA组、恶性血液病患者及健康志愿者血小板特异性抗体总阳性率分别为 6 9.99% ,10 % ,2 0 %和 0 %。ITP组与CAA组存在显著性差异 ( χ2 =2 0 .71,P <0 .0 0 5 ) ,ITP组与恶性血液肿瘤化疗组存在显著性差异 ( χ2 =12 .2 2 ,P <0 .0 0 5 )。健康志愿组无 1例阳性。结论 :多种抗体同时检测可提高敏感性 ,血小板特异性抗体对ITP是一种特异性高、敏感性强的实验室诊断指标。

The Diagnostic Value of Platelet Glycoprotein-Specific Autoantibody Detection in Idiopathic Thrombocytopenic Purpura

To detect levels of platelet glycoprotein-specific autoantibody in idiopathic thrombocytopenic purpura (ITP), chronic aplastic anemia (CAA), hematologic malignancies and healthy volunteers, and evaluate the clinical significance of platelet glycoprotein-specific autoantibody level in diagnosis for ITP, anti-GPIb/IX, anti-GPIIb/IIIa, anti-GPIV and anti-GPV auto-antibodies were detected contemporaneously by a modified monoclonal antibody immobilization of platelet antigen assay (modified MAIPA). The results showed that the total positive rate of antibodies against platelet GPIb/IX, GPIIb/IIIa, GPIV, GPV were 69.99%, 10%, 20% and 0% in ITP, CAA, hematologic malignancy group and healthy volunteers respectively. There was significant difference between ITP and CAA (chi(2) = 20.71, P < 0.005), between ITP and hematologic malignancy group (chi(2) = 12.22, P < 0. 005). There was no positive finding in the healthy control. It is concluded that platelet glycoprotein-specific autoantibody has high value for the diagnosis of ITP,many kinds of antibodies detection at one time can enhance sensitivity, MAIPA is a specific assay for the diagnosis of idiopathic thrombocytopenic purpura.