TPA诱导的血小板聚集的研究

应用不同浓度ＴＰＡ诱发血小板聚集，观察２０名正常人血小板的聚集率。结果显示：ＴＰＡ从５ｎｇ／ｍｌ到１０ｎｇ／ｍｌ之间，随着浓度的增加，血小板聚集率逐渐增加，最佳浓度为１０ｎｇ／ｍｌ。当ＴＰＡ浓度〉１０ｍｇ／ｍｌ时，继续增加ＴＰＡ浓度，血小板聚集率将不再升高，且于２０ｍｇ／ｍｌ时出现明显的解聚现象。     

“90增血剂”对特发性血小板减少性紫裥患者的T细胞亚群的作用

作者根据现代免疫学观点,自1989年起采用自制中药“90增血剂”治疗ITP46例。期间,应用间接免疫荧光技术检测了患者外周血T淋巴细胞亚群,结果表明病例组全T细胞(CD_3)、T辅助/诱导细胞(CD_4)降低,T抑制/细胞毒细胞(CD_8)增高,CD_4/CD_8比值明显降低。治疗后,患者T亚群恢复常态,血小板数上升,骨髓产板型巨核细胞数增加,临床总有效率达91.2%,明显优于激素组(71.4%)。提示中药具有显著的疗效和良好的免疫调节作用。同时,动态观察ITP患者T细胞亚群的变化,对帮助临床判断治疗反应和预后有很大意义。     

Aussagekraft der präoperativen Thrombozytenmarkierung bei Patienten mit idiopathischer thrombozytopenischer Purpura

Summary ⁵¹Cr-platelet kinetic studies were performed in 77 patients with idiopathic thrombocytopenic purpura. The sequestration site was splenic for 63, splenic/hepatic for 7 or hepatic for remaining 7 patients. In 20 patients platelet survival was extremely shortened to 0–3 h, whereas only 26 patients had a survival time of more than 24 h. Those patients with low platelet counts also had a very short platelet survival time, whereas patients with higher platelet counts (>50×10⁹/l) had longer platelet survival times. 51 patients (66%) were splenectomized following the kinetic studies. 25 patients who had a splenic sequestration site had normalized platelet counts and 6 patients had platelet counts between 80–149×10⁹/l 12 months after splenectomy (i.e. in 92% of cases with splenic sequestration site a full or partial remission). Of the 11 patients with a hepatic or splenic/hepatic sequestration site, 2 patients had full remission, 1 partial remission, 3 patients had minimal improvement and 5 other patients were treatment failures in respect to the splenectomy.

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Abkürzungen ACD-A Acid-Citrat-Dextrose Lösung A - HBsAge Hepatitis-B Oberflächen-Antigen - ITP idiopathische thrombozytopenische Purpura - PAIgG plättchenassoziierte IgG-Antikörper - TRP thrombozytenreiches Plasma     

ITP患者骨髓及血液检测指标与疗效关系的探讨

目的：为观察血小板表面相关抗体Ｇ（ＰａＩｇＧ）、外周血血小板计数（ＢＰＣ）、平均血小板容积（ＭＰＶ）、骨髓巨核细胞计数（ＭＫ）与产板型巨核细胞比例（ＰＰＭＫ）对特发性血小板减少性紫癜（ｉｄｉｏｐａｔｈｉｃ ｔｈｒｏｍｂｏｃｙｔｏｐｅｎｉｃｐｕｒｐｕｒａ,ＩＴＰ）患者疗效的预计价值。方法：采用Ｃｏｕｌｔｅｒ全自动血球分析仪及双抗体夹心ＥＬＩＳＡ法等,对７３例ＩＴＰ患者治疗前和治疗后的ＢＰＣ、ＭＰＶ、     

血得安治疗小儿特发性血小板减少性紫癜的疗效观察

目的 总结中药血得安治疗小儿ITP的疗效结果。方法 采用中药治疗组与西医对照组,观察其疗效。结论 治疗组总有效率91.66%,对照组75%。中药能明显提高患儿血小板数、并降低PAIgG水平。     

免疫法建立特发性血小板减少性紫癜动物模型过程的改进及其体会

特发性血小板减少性紫癜(ITP)是临床常见的免疫疾病,主要是由于自身抗体同血小板结合,引起血小板的破坏增多.鉴于与其自身免疫相关的发病特点,本病的研究必须建立在与疾病本质相似的动物模型上.目前国内对ITP的实验研究主要采用免疫法造模[1,2],或者免疫法结合其它方法造模[3,4].笔者在实验中从经济有效的角度对该法进行了进一步摸索并稍加改进.     

紫癜颗粒对ITP模型小鼠外周血小板的影响

目的观察ITP模型小鼠外周血小板数量与功能的变化情况,探讨血小板在ITP发病中的作用.方法采用全自动血细胞分析仪检测外周血小板计数,采用流式细胞仪检测CD41(抗GPⅢ3a)、CD61(抗GPⅡb).结果注射抗血小板血清(APS)后ITP模型小鼠外周血小板计数明显下降,同时CD41、CD61也明显降低,差异有显著性意义(P＜0.05);紫癜颗粒大剂量组与醋酸泼尼松组均能显著提升血小板计数;紫癜颗粒大剂量组可使CD41、CD61恢复正常水平.结论 ITP存在血小板数量的减少及功能的异常;中药复方紫癜颗粒可明显提高外周血小板数量,还可恢复血小板聚集功能,且远期疗效优于醋酸泼尼松.     

Prevalence and Characterization of Thrombocytopenia in Pregnancy in Indian Women

To find the prevalence and causes of thrombocytopenia during pregnancy. An analytical prospective observational study was conducted in Department of Obstetrics & Gynecology, CSMMU, Lucknow. 1079 antenatal women screened for thrombocytopenia and investigated for cause and management strategies and fetomaternal outcome were recorded. Prevalence of thrombocytopenia was 8.8%. Gestational thrombocytopenia was seen in 64.2%, obstetric in 22.1% and medical in 13.68% cases. Mean platelet count in controls was lower with a significant fall (P < 0.001) in the platelet count as pregnancy advanced. Hypertensive and hepatic disorders were the most common obstetric causes of thrombocytopenia. Mode of delivery was not affected by thrombocytopenia. Maternal morbidity and mortality was seen only in medical and obstetric thrombocytopenia. The low platelet counts and declining trend with increasing gestational age predispose Indian women to risk of thrombocytopenia and a routine platelet count is suggested.     

ITP患者血小板活化依赖性自身抗原的研究

本文采用改良单克隆抗体特异性抗原捕获酶免疫法(MACE)使用5种抗原血小板单克隆抗体对59例ITP患者进行了相关自身抗原研究,结果28例ITP患者血浆呈现抗血小板自身抗体阳性(47.46％),其中单独抗GPI_b/2例、抗GPⅡ_b/Ⅲ_α5例、抗α颗粒膜蛋白-1401例,抗凝血酶敏感蛋白6例,另14例出现2种以上自身抗体,以抗GPⅡ_b/Ⅲ_α为多见。找们建议将以上抗体针对的抗原称为血小板活化依赖性自身抗体。虽然我们未发现这类自身抗原与其它类型自身抗原间的临床表现及治疗结果存在明显差异,但这类自身抗原应引起重视,有必要对此作进一步观察和深入研究。