特发性血小板减少性紫癜患者血清可溶性B淋巴细胞刺激因子的表达

目的研究特发性血小板减少性紫癜（ITP）患者血清可溶性B淋巴细胞刺激因子（BLyS）的水平，以明确BLyS是否在ITP患者中存在异常的BLyS表达。方法共有41例ITF-患者进入本研究，正常对照由22例年龄性别匹配的健康人组成。血清可溶性BLyS水平以ELISA方法检测。结果未接受治疗的ITP患者BLyS水平（中位数1430pg／mL，534--5787pg／mL）高于正常对照（中位数1120pg／mL，640--2376pg／mL，P=0．006）和ITP接受治疗组（中位数662pg／mL，267～1265pg／mL，P=0．000）。而ITP甲治疗组血清BLyS水平低于正常对照（P=0．001）。血小板计数和BLyS水平之间存在弱的相关关系（Pearson相关系数一0．242，P=0．064）。但BLyS水平与PAIg及免疫球蛋白水平无关。且急慢性ITP患者的BLyS水平之间没有差别（P=0．841）。结论BLyS可能参与了ITP自身免疫的发病过程。但是将血清BLyS水平作为ITP疾病活性标志物尚须谨慎．

The serum levels of BLyS in Idiopathic Thrombocytopenic Purpura

Objectives To further explore the role of BLyS （B lymphocyte stimulator） in the pathogenesis of idiopathic thromhocytopenic purpura （ITP）, the serum BLyS levels were determined and the correlation between the clinical parameters and the BLyS expression levels was analyzed. Methods Serum was obtained from 41 patients with ITP and 22 compatible healthy volunteem and was analyzed with a ELISA kit. Results The untreated patients with ITP had higher serum BLyS levels （Median 1 430 pg/mL, Range： 534--5 787 pg/mL） than those of normal controls （Median 1 120 pg/mL, Range 640--2 376 pg/mL, P=0.006） and treated ITP group （Median 662 pg/mL, Range 267--1 265 pg/mL, P=0.000）. On the other hand, serum BLyS levels of treated patients with ITP were lower than those of normal controls （P = 0. 001）. There was a loose correlation （the Pearson correlation coefficient -0. 242） between platelet count and BLyS （P = 0. 064）. However, BLyS levels did not correlate with PAIg or immunoglobulin levels. Moreover, the serum BLyS levels were not statistically different between acute and chronic ITP （P = 0. 841）. Conclusions BLyS might contribute to autoimmunity and disease development in ITP. However, BLyS serum level must be carefully considered as a surrogate marker of disease activity in ITP.