流式细胞术检测血小板相关抗体在免疫性血小板减少症中的应用

目的：探讨流式细胞术检测血小板相关抗体在免疫性血小板减少症（ITP）的临床应用价值。方法60例健康体检者、51例 ITP 患者（23例新诊断 ITP 患者、28例持续性 ITP 患者）和21例非 ITP 继发性血小板减少症患者的血小板相关抗体， PAIg 的表达率及荧光强度，与血小板、巨核细胞数量进行相关性分析；分析持续性 ITP 经过治疗后与治疗前的 PAIg 表达率。结果ITP 患者组 IgG、IgA 和 IgM 的荧光阳性百分率和平均荧光强度均明显高于健康对照组，差异有统计学意义（P ＜0．01）。与非免疫性血小板减少组比较，差异有统计学意义（P ＜0．05）。与自身免疫病比较，差异无统计学意义（P ＞0．05）。非免疫性血小板减少组与健康对照组比较，差异无统计学意义（P ＞0．05）；自身免疫病组与健康对照组比较，差异有统计学意义 P ＜0．01；在持续性 ITP 治疗患者中，完全反应（complete response，CR）组的 PAIg 与治疗前进行组间比较，差异有统计学意义（P ＜0．01）。有效（response，R）组的 PAIg 与治疗前组间比较，差异具有统计学意义（P ＜0．05）。结论流式细胞术检测 PAIg 可以用于 ITP 诊断、鉴别诊断和病情监测。

Application of flow cytommetry detection of platelet associated antibody in patients with immune thrombocytopenic pupura

Objective To investigate the value of the flow cytometry（FCM）for detecting platelet associated antibody in the di-agnosis of immune thrombocytopenia（ITP）.Methods Platelet associated antibody,expression rate and the fluorescence intensity of platelet-associated immunoglobulin（PAIg）were measured in 51 patients with ITP（23 cases of newly diagnosed ITP and 28 cases of persistent ITP）,21 patients with non-ITP and 60 healthy individuals.The correlation between the detection results with the platelet and megakaryocyte counts was performed;the expression rates of PAIg before and after treatment were compared.Results The fluorescence positive percentage and mean fluorescence intensity of IgG,Ig A and IgM in the patients group were significantly high-er than those in the control group with statistical difference（P 0.05）;the difference between the autoimmune disease group and the healthy control group had statistical significance（P 〈0.01 ）;in the persistent ITP group,PAIg in the complete response group had statistical difference between the groups before treament.PAIg in the response group also had statistical difference between the groups before treament （P 〈0.05）.Conclusion FCM for detecting PAIg can be used in the diagnosis,differential diagnosis and the disease condition monitoring of ITP.