免疫抑制治疗无效的特发性血小板减少性紫癜患者血小板相关免疫球蛋白的亚型分析

目的分析糖皮质激素、环孢菌素A治疗无效的特发性血小板减少性紫癜(ITP)患者血小板相关免疫球蛋白(PAIg)的亚型。方法采用酶联免疫法(ELISA)对19992004年绵阳市中心医院收治的17例激素治疗无效、4例激素 环孢菌素A治疗无效以及30例激素治疗有效ITP患者的PAIg亚型进行检测。结果17例激素治疗无效的患者PAIg各亚型抗体较之激素治疗有效ITP患者差异有显著性(P<0·01),激素治疗无效组PAIg各亚型水平均明显增高;激素 环孢菌素A治疗无效组PAIgM较之激素治疗有效ITP患者有所增高(P<0·05)。结论激素治疗无效的ITP患者PAIg各亚型均显著增高,提示PAIg在介导ITP患者异常免疫反应过程中起重要作用,PAIg各亚型水平的增高可能有助于预测ITP患者对激素治疗的敏感性。

Analysis of platelet-associated immunoglobulin subsets in idiopathic thrombocytopenia purpuras resistant to immuno therapy

Objective To analyse platelete associated immunoglobulin(PAIg)subsets in idiopathic thrombocytopenia purpuras resistant to prednisone and cyclosporine.Methods Evaluate PAIg subsets in seventeen ITP patients resistant to prednisone,four cases resistant to both prednisone and cyclosporine,thirty in-patients responding to prednisone as the control.All patients were admitted from 1999 to 2004.Results The levels of PAIgA,PAIgG and PAIgM were significantly higher in the seventeen ITP patients resistant to prednisone than that in the thirty cases responsive to prednisone(P<0.01).In those resistant to prednisone and cyclosporine,the levels of PAIgA and PAIgG were similar to the control except that the level of PAIgM was higher(P<0.05).Conclusion The high levels of PAIgs in those patients resistant to prednisone indcate that PAIg plays an important role in the pathogenesis of ITP.In some degree,the elevation of PAIg can predict whether the ITP patient is sensitive to prednisone.Furthermore,PAIgM may be another major factor that takes part in the abnormal immune reactions in the cases resistant to prednisone and cyclosporine.