流式细胞术检测血小板相关抗体和CD 61诊断特发性血小板减少性紫癜

目的探讨流式细胞术（flow cytometry method,FCM）联合检测血小板表面CD 61和血小板相关抗体（PAIg）在特发性血小板减少性紫癜（idiopathic thrombocytopenic purpura,ITP）诊断和鉴别诊断中的价值。方法用FCM法检测30例健康体检者、59例ITP患者和24例继发性血小板减少非ITP患者PAIg（包括PAIgA、PAIgM、PAIgG）表达率、荧光强度和CD 61表达率,并对三组人群结果进行比较;并将ITP患者PAIg、CD 61表达水平与血小板数量进行相关性分析。结果 ITP患者和非ITP继发性血小板减少患者的PAIgA、PAIgM、PAIgG表达率和荧光强度均显著高于健康对照组（均P〈0.01）;然而,两组患者之间比较,差异均无显著性意义（P〉0.05）。ITP组CD 61表达率显著低于非ITP组（P〈0.05）,而非ITP组和对照组无显著性差异（P〉0.05）。PAIgA、PAIgM、PAIgG与血小板计数均呈显著负相关,其中以PAIgA相关性最强。重度ITP患者PAIg表达率明显高于轻度ITP患者,而CD 61表达率显著低于轻度ITP患者,两组差异均有显著差异（P〈0.05）。结论同时检测血小板表面CD 61和PAIg可以用于ITP诊断、鉴别诊断和病情监测,流式细胞术具有灵敏、快速、简便等特点,具有较好的实用价值。

Diagnosing ITP by Measuring the CD 61 and PAIg with FCM

Objective To evaluate the value of measuring CD 61 on the surface of platelet and the platelet-associated antibody PAIg by FCM in the diagnosis and antidiastole of ITP.Methods With FCM,we measured the positive pecentage of CD 61,and the positive pecentage and epipolic strength of PAIg（including PAIgA,PAIgM,PAIgG）.All people were divided into three groups：healthy people group（30 patients）,ITP group（59 patients） and non-ITP group（24 patients）.We compared the healthy people group with the ITP and the non-ITP,and did the correlation analysis of PAIg,CD 61 and number of platelet in ITP patients.Results Compare the healthy people group with the other two groups respectively,the positive pecentage and epipolic strength of the two patient groups are both higher（P0.01）,however,the difference is not significant in statistics respectively（P0.05）.The positive pecentage of CD 61 in the ITP group is lower than the non-ITP group（P0.05）.and there is no significant difference between the non-ITP group and the healthy people group.The number of platelet is negative correlation with PAIgA,PAIgM and PAIgG,and the correlation with PAIgA is the strongest.CD 61 lower in ITP group,however,there is no correlation with the number of platelet.The positive pecentage of PAIg of patients,whose ITP are at high stage,is higher than the patients whose ITP are at low stage.However,the positive pecentage of CD 61 is higher in the patients whose ITP are at low stage,and the difference is significant in statistics（P0.05）.Conclusion It is valuable to measure the CD 61 and PAIg with FCM in the diagnosis,antidiastole and monitoring of ITP.Also,FCM is more sensitive,fast and convenient.