血小板减少性紫癜血小板特异性抗体和促血小板生成素检测的临床意义

目的探讨特发性血小板减少性紫癜(ITP)患者抗血小板膜糖蛋白(GPⅡb/Ⅲa、GPIb/Ⅸ)特异性抗体表达和促血小板生成素(TPO)水平与血小板计数(PLT)之间的关系。方法应用改良血小板抗原单克隆抗体固相化检测技术(MAIPA)、酶联免疫吸附法(ELISA)检测50例ITP患者和30名健康对照抗GPⅡb/Ⅲa、GPⅠb/Ⅸ特异性抗体及血清TPO水平,同时检测其PLT及骨髓巨核细胞数。结果抗GPⅡb/Ⅲa及GPⅠb/Ⅸ抗体吸光度(A值)均高于健康对照组(P<0.05);血清TPO较健康对照组升高,差异无统计学意义(P>0.05),相关分析表明ITP组血小板计数与两种特异性抗体水平呈负相关;ITP患者血清TPO水平与血小板计数、骨髓巨核细胞数无相关性(P>0.05)。结论血小板膜糖蛋白特异性抗体检测对确定ITP诊断有重要意义,血清TPO检测对探讨血小板生成的调节机制及辅助ITP的诊断有一定意义。

The clinical significance of test on serum level of thrombopoietin and platelet specific autoantibody in patients with ITP

Objective To test the level of thrombopoietin （TPO）, the expressions of anti-GPⅡb/Ⅲa and anti- GPⅠb/Ⅸ specific autoantibody in patients with idiopathic thrombocytopenic purpura （ITP） and to explore their relationship with peripheral blood platelet counts. Methods The level of TPO and expression of Anti-GPⅡb/Ⅲa and anti-GPⅠb/Ⅸ autoantibodies in 50 patients with ITP and 30 healthy controls were tested by monoclonal antibody immobilization of platelet antigens assay （modified MAIPA） and enzyme-linked immunosorbent assay （ELISA）. Blood counts of platelets and megakaryocytes in these subjects were also obtained. Results Optical density （A） of anti-GPⅡb/Ⅲa and anti-GPⅠb/Ⅸ autoantibodies was much higher in ITP patients than in normal controls （P〈0.05）. ITP patients also had higher level of TPO compared with normal controls, but the difference was not statistically significant （P〉0.05）.An inverse correlation between the expression of each of the autoantibodies and the platelet counts in ITP was found. Conclusion The expression of platelet glycoprotein-specific autoantibody may have a major role in the diagnosis of ITP. Serum level of TPO can he useful for study of regulatory mechanisms of platelet generation and diagnosis of ITP.