特发性血小板减少性紫癜患者血小板抗体及淋巴细胞亚群的研究

目的探讨血小板相关抗体(PAIgG)和T淋巴细胞亚群的变化,在特发性血小板减少性紫癜(ITP)免疫发病机制中的作用、临床意义。方法采用间接免疫荧光法测定30例ITP患者及20例正常对照组的PAIgG,20例ITP患儿治疗后复查PAIgG。同时采用流式细胞仪直接免疫荧光法检测外周T血淋巴细胞亚群。结果ITP组PAIgG阳性率为80%,正常对照组为20%(P<0.001),ITP组PAIgG明显高于正常对照组(P<0.001),20例ITP患儿治疗后复查PAIgG,其数值明显下降,差异有显著性(P<0.001)。T淋巴细胞亚群中,ITP组CD3、CD4、CD4/CD8显著低于正常对照组(P<0.01),CD8则显著高于正常对照组(P<0.01)。结论抗血小板相关抗体对提高ITP的诊断、疗效及预后的判断有一定的实用价值,T淋巴细胞亚群的变化能较好的反映ITP的病理机制。

Autoantibodies against platelet and lymphocyte subpopulations in patients with idiopathic thrombocytopenic purpura

Objective To assess the changes of lymphocyte subsets and autoantibodies against platelet (PAIgG) to explore the pathological mechanism and clinical significance in idiopathic thrombocytopenic purpura (ITP). Methods PAIgG were measured by indirect immunofluorescence in 30 ITP patients and 20 normal controls. 20 of the 30 patients were followed up to test there PAIgG after treatment. Lymphocyte subpopulations in 30 patients were measured by using flowcytometry(FCM) before and after treatment. Results The positive rate of PAIgG in ITP patients was 80%,which was significantly higher than that in normal controls 20%(P<0. 001). After treatment the level of PAIgG was significantly reduced in ITP patients compared to control group(P<0. 001) . The percentage of CD3,CD4 cell and ratro of CD4/CD8 cell was significantly lower on ITP patients than that in normal controls(P<0.01),and the percentage of CD8 cell in ITP patients was increased significantly(P<0.01).Conclusions The autoantibodies against platelets and the changes of lymphocyte subpopulations can reflect the pathogenesis of ITP,which may be improve as valuable markers for the diagnose,treatment and prognosis in ITP patients.