特发性血小板减少性紫癜患者外周血淋巴细胞亚群和血小板特异性抗体检测的临床意义

目的 检测特发性血小板减少性紫癜(ITP)患者外周血淋巴细胞亚群、血小板膜糖蛋白(GPⅡb/Ⅲa、GPⅠb/Ⅸ)特异性抗体变化,探讨相关因素在ITP发病机制中的作用.方法 用流式细胞术检测72例ITP患者(ITP组)和50例健康体检者(对照组)外周血淋巴细胞亚群CD3+、CD4+、CD8+、CD4+/CD8+、CD19+变化.应用改良血小板抗原单克隆抗体固相化检测技术测定GPⅡb/Ⅲa、GPⅠb/Ⅸ特异性抗体变化.结果 ITP组与对照组比较,GPⅡb/Ⅲa、GP Ⅰ b/Ⅸ特异性抗体吸光度值升高(P＜0.05),CD3+、CD4+、CD4+/CD8+显著下降(P＜0.01),CD8+、CD19+显著增高(P＜0.01).结论 淋巴细胞亚群及血小板特异性抗体可较好地反映ITP的病理机制,在ITP的发病机制中起非常重要的作用.

Clinical significance of lymphocyte subsets and platelet specific antibodies in patients with idiopathic thrombocytopenic purpura

Objective To test the changes of lymphocyte subsets and anti-GP Ⅱ b/Ⅲa,anti-GP Ⅰ b/Ⅸ specific antibodies in patients with idiopathic thrombocytopenic purpura(ITP),and discuss the related factors involved in pathogenesis of ITP.Methods The changes of lymphocyte subsets CD3+,CD4+,CD8+,CD4+CD8+,CD19+ in 72 patients with ITP (ITP group) and 50 healthy controls (control group) were measured by flow cytometry (FCM).Expression of anti-GP Ⅱ b/Ⅲ a,anti-GP Ⅰ b/Ⅸ specific antibodies were tested by monoclonal antibody immobilization of platelet antigens assay (modified MAIPA).Results Optical density of anti-GP Ⅱ b/Ⅲ a,anti-GP Ⅰ b/Ⅸ specific antibodies in ITP group was much higher than that in control group (P ＜0.05).In changes of lymphocyte subsets,the number of the CD3+,CD4+,CD4+/CD8+ in ITP group were obviously lower than those in control group (P ＜0.01),but CD8+ and CD19+ were much higher than those in control group(P ＜0.01).Conclusions Expression of lymphocyte subsets and platelet specific antibodies can reflect the pathogenesis of ITP well.The abnormal function and ratio of lymphocyte subsets,as well as the immunologic mechanism disorder of lymphocytes play important roles in the pathogenesis of ITP.