免疫性血小板减少症患者血清ANA、BAFF异常及临床意义的研究

目的:探讨成人免疫性血小板减少症(ITP)患者血清抗核抗体(ANA)临床特点及与B细胞活化因子(BAFF)之间的关系以及预后意义。方法:分析初治ITP患者70例,研究患者免疫学异常特点,观察患者ANA与临床表现、近期疗效的关系;动态分析ITP患者43例,观察有无进展为SLE等结缔组织病;ELISA检测ANA阳性患者与阴性患者BAFF有无差异。结果:ITP患者存在多项免疫异常,ANA阳性、抗干燥综合征抗原(SSA)阳性、IgG增加比例高;起病时ANA阳性患者血小板计数(PLT)较ANA阴性患者低,出血症状较ANA阴性患者重;ANA阳性患者BAFF水平高于阴性患者;ANA阳性患者对激素治疗的近期疗效优于ANA阴性患者;43例动态分析患者平均随访期限为(48.44±4.80)月,2例随访过程中进展为SLE,均为较高滴度(分别为6.23和4.1)的ANA阳性患者。结论:起病时ANA阳性患者病情较重,对激素治疗的近期疗效较ANA阴性患者好,ANA阳性患者BAFF水平高,ANA可能与ITP发病及病情进展有一定关系。

Clinical significance of serum ANA and B cell-activating factor in idiopathic thrombocytopenic purpura

Objective:To determine the clinical significance of the antinuclear antibody(ANA) and B cell-activating factor(BAFF) in adult patients with immune thrombocytopenia(ITP).Methods:We conducted a retrospective analysis of 70 adult patients with ITP for their clinical features.43 Patients were regularly followed-up for development of symptoms indicative of autoimmune disorder.The BAFF level in peripheral blood(PB)was tested with ELISA in some patients.Results:ANA and SSA positive were often found in adult patients with ITP.The platelets count(PLT) were lower in ANA positive group than those in ANA negative group.The serious bleeding was more common in ANA positive group.The BAFF level was higher in ANA positive group than that in ANA negative group.ITP patients can have high remission ratio after steroid therapy in ANA positive group than those in ANA negative group.Mean follow-up(48.44±4.80) months,two patients with a high-titer positive ANA developed SLE.Conclusion:ANA positive may be an indicator in terms of severity for adult ITP.ANA positive ITP patients have high remission ratio after steroid therapy.ANA might contribute to disease development in ITP.