[血小板膜自身抗体对特发性血小板减少性紫癜患者大剂量地塞米松治疗的影响]
[The impact of platelet membrane autoantibodies on high-dose dexamethasone therapy in patients with idiopathic thrombocytopenic purpura].
作者信息
Wang Rui, Qin Ping, Ji Xue-bin, Hou Ming
机构信息
Department of Hematology, the Tumor Center, QiLu Hospital of Shandong University, Jinan 250012, China.
出版信息
Zhonghua Xue Ye Xue Za Zhi. 2009 Sep;30(9):619-21.
OBJECTIVE
To evaluate the impact of platelet membrane glycoprotein (GP)-specific autoantibodies on high-dose dexamethasone therapy in patients with idiopathic thrombocytopenic purpura (ITP).
METHODS
Modified direct monoclonal antibody immobilization of platelet antigen assay (MAIPA) was used to detect platelet GPIIb/IIIa and/or GPI b specific autoantibodies. All patients received oral dexamethasone 40 mg/d for 4 days.
RESULTS
The response rate of high-dose dexamethasone in GPIIb/IIIa and/or GPIb specific autoantibody-negative patients was significantly different from that of antibody-positive patients (P<0.05). The response rate of GPIIb/IIIa specific autoantibody-positive patients was lower than that of antibody-negative patients (P<0.05). GPIb specific autoantibody had no significant impact on the efficacy of high-dose dexamethasone (P>0.05).
CONCLUSION
Platelet membrane GPIIb/IIIa-specific autoantibody can be a potential negative indicator for ITP patients'response to high-dose oral dexamethasone.
目的
评估血小板膜糖蛋白（GP）特异性自身抗体对特发性血小板减少性紫癜（ITP）患者大剂量地塞米松治疗的影响。
方法
采用改良的血小板抗原单克隆抗体固相检测法（MAIPA）检测血小板GPIIb/IIIa和/或GPIb特异性自身抗体。所有患者口服地塞米松40mg/d，共4天。
结果
GPIIb/IIIa和/或GPIb特异性自身抗体阴性患者大剂量地塞米松的缓解率与抗体阳性患者有显著差异（P<0.05）。GPIIb/IIIa特异性自身抗体阳性患者的缓解率低于抗体阴性患者（P<0.05）。GPIb特异性自身抗体对大剂量地塞米松的疗效无显著影响（P>0.05）。
结论
血小板膜GPIIb/IIIa特异性自身抗体可能是ITP患者对大剂量口服地塞米松反应的潜在阴性指标。
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