CAJ | 학술논문

目的检测特发性血小板减少性紫癜(ITP)患者体内的血小板特异性自身抗体与临床严重程度和临床疗效间的关系. 方法应用改良的单克隆抗体特异性俘获血小板抗原(MAIPA)法检测血小板膜糖蛋白(GPⅡ bⅢa、GPIb)特异性自身抗体. 结果 ITP组(40例),10例为单一抗GPⅡ b Ⅲa抗体阳性.6例为单一抗GPIbα抗体阳性,20例为双抗体阳性,4例为双抗体阴性.非免疫性血小板减少组与正常对照组均为阴性.抗GPⅡbⅢa抗体(b=-0.071,P<0.01)、抗GPlbα抗体(b=-0.092,P<0.01)均与采血时血小板计数呈显著负相关.治疗后,双抗体阳性组8例治疗无效,单抗体阳性组(16例)1例治疗无效(χ2=6.09,P<0.05). 结论血小板特异性自身抗体检测对鉴别特发性和非免疫性血小板减少症有一定价值.抗体种类与临床疗效有一定关系.
목적 검측특발성혈소판감소성자전(ITP)환자체내적혈소판특이성자신항체여림상엄중정도화림상료효간적관계. 방법 응용개량적단극륭항체특이성부획혈소판항원(MAIPA)법검측혈소판막당단백(GPⅡ bⅢa、GPIb)특이성자신항체. 결과 ITP조(40례),10례위단일항GPⅡ b Ⅲa항체양성.6례위단일항GPIbα항체양성,20례위쌍항체양성,4례위쌍항체음성.비면역성혈소판감소조여정상대조조균위음성.항GPⅡbⅢa항체(b=-0.071,P<0.01)、항GPlbα항체(b=-0.092,P<0.01)균여채혈시혈소판계수정현저부상관.치료후,쌍항체양성조8례치료무효,단항체양성조(16례)1례치료무효(χ2=6.09,P<0.05). 결론 혈소판특이성자신항체검측대감별특발성화비면역성혈소판감소증유일정개치.항체충류여림상료효유일정관계.
Objecfive To detect the specific autoantibodies against platelet in idiopathic thrombocytopenic purpura (ITP) and to study the relationship between these autoantibodies and the severity of ITP as well as therapeutic effect.Methods Autoantibodies (GPⅡbⅢa and GPIb) against platelet glycoprotein was measured by a monoclonal antibody immobilization of platelet antigen assay (MAIPA) in 40 ITP patients.Results 10 patients had mono-specific antibodies to GP Ⅱ bⅢa and 6 patients had mono-specific antibodies to GPIbα.Another 20 patients had antibodies to both antigens and 4 patients had no detectable antibody to either platelet antigen.There Was negative correlation between the antibody against GPⅡbⅢa(b=-0.071,P<0.01),CPIbα(b=0.092,P<0.01) and platelet counts.The ratio of refractory cases in patients with antibodies to both antigens(8/20) was significantly higher than that in patients with mono-specific antibodies(1/16)(χ2=6.09,P<0.05).Conclusion The specific autoantibadies against platelet might be valuable for discrininafion of idiopathic thrombocytopenic purpura and non immune thrombocytopenia.The types of antibodies are related with severity of ITP and therapeutic effect.