[原发性免疫性血小板减少症中抗血小板膜糖蛋白自身抗体表达与治疗效果的关系]

[Relationship between the expression of autoantibodies against platelet membrane glycoprotein and therapeutic effect in primary immune thrombocytopenia].

作者信息

Liu Xiao-fan, Xue Feng, Zhang Lei, Zhou Xue-li, Liu Yong-ze, Liu Wei, Chen Yun-fei, Huang Yue-ting, Yang Ren-chi

机构信息

Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China.

出版信息

Zhonghua Xue Ye Xue Za Zhi. 2013 Jul;34(7):610-3. doi: 10.3760/cma.j.issn.0253-2727.2013.07.011.

DOI:10.3760/cma.j.issn.0253-2727.2013.07.011

PMID:23906456

Abstract

OBJECTIVE

To study the expression of specific anti- platelet glycoprotein autoantibodies GP II b/III a, GP I b/IX and GP I a/II a in primary immune thrombocytopenia (ITP), and to evaluate the relationship between the therapeutic effect and the expression of specific anti- platelet glycoprotein antibodies GPIIb/IIIa, GPIb/IX and GPIa/IIa.

METHODS

Anti-GPIIb/IIIa, GPIb/ IX and GP I a/II a antibodies were assayed by ELISA for patients with ITP. Total 442 patients in our hospital, who were retrospectively investigated from December 2010 to November 2012, were divided into newly diagnosed ITP, persistent and chronic ITP. The expression of specific anti- platelet glycoprotein antibody in each group was measured separately. The newly diagnosed ITP patients were treated with intravenous IgG (IVIG) and corticosteroids. The relationship between the expression of specific anti- platelet glycoprotein antibodies GPIIb/IIIa, GPIb/IX and GPIa/IIa and the complete response (CR) was studied.

RESULTS

Positive rates of anti- platelet glycoprotein antibodies were 59.09%, 26.97% and 37.35% respectively in newly diagnosed ITP, persistent and chronic ITP, the difference was statistical significant (P<0.05). In newly diagnosed ITP, positive rate of antibody against GPIIb/IIIa was 38.64%, double positive rate of antibodies against both GP II b/III a and GP I a/II a was 15.91%, there was statistical significance (P<0.05) compared with that of persistent and chronic ITP. The complete response (CR) rate in newly diagnosed ITP patients with positive antibody against GP II b/III a was 80.39% after treatment with IVIG and corticosteroids. There was statistical significance compared with that in patients having no antibodies (P<0.05).

CONCLUSION

The expression of antibodies against GP II b/III a and double positive for both GP II b/III a and GP I a/II a autoantibodies increased in newly diagnosed ITP patients. Patients with anti-GP II b/III a autoantibody had good response to medication with IVIG and corticosteroids.

摘要

目的

研究原发性免疫性血小板减少症（ITP）中特异性抗血小板糖蛋白自身抗体GP II b/III a、GP I b/IX和GP I a/II a的表达情况，并评估特异性抗血小板糖蛋白抗体GPIIb/IIIa、GPIb/IX和GPIa/IIa的表达与治疗效果之间的关系。

方法

采用酶联免疫吸附测定法（ELISA）检测ITP患者的抗GPIIb/IIIa、GPIb/ IX和GP I a/II a抗体。对我院2010年12月至2012年11月期间回顾性调查的442例患者进行分组，分为新诊断ITP组、持续性ITP组和慢性ITP组。分别测定每组中特异性抗血小板糖蛋白抗体的表达情况。对新诊断的ITP患者采用静脉注射免疫球蛋白（IVIG）和糖皮质激素进行治疗。研究特异性抗血小板糖蛋白抗体GPIIb/IIIa、GPIb/IX和GPIa/IIa的表达与完全缓解（CR）之间的关系。

结果

新诊断ITP组、持续性ITP组和慢性ITP组抗血小板糖蛋白抗体阳性率分别为59.09%、26.97%和37.35%，差异有统计学意义（P<0.05）。新诊断ITP组中，抗GPIIb/IIIa抗体阳性率为38.64%，抗GP II b/III a和GP I a/II a双阳性率为15.91%，与持续性ITP组和慢性ITP组相比有统计学意义（P<0.05）。新诊断的ITP患者中，抗GP II b/III a抗体阳性者经IVIG和糖皮质激素治疗后完全缓解（CR）率为80.39%。与无抗体患者相比有统计学意义（P<0.05）。