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特发性血小板减少性紫癜中血小板抗体的检测(作者译)

[Detection of platelet antibodies in idiopathic thrombocytopenic purpura (author's transl)].

作者信息

Goudemand J, Caulier M T, Bauters F, Cosson A, Goudemand M

出版信息

Nouv Rev Fr Hematol (1978). 1979;21(1):47-56.

PMID:573887
Abstract

The amount of IgG present on the surface of platelets (platelet-bound IgG, or PBIgG) was measured using a quantitative antiglobulin consumption assay developed by Dixon et al. (1975). Normal platelets or platelets from patients with thrombocytopenia due to a decreased production had less than 10 X 10(-15) g of IgG/platelet. Studied were 364 blood samples drawn from 196 patients; 173 patients had idiopathic thrombocytopenic purpura; 65 (93 %) of 70 in the acute phase of their disease had elevated PBIgG (values up to 100 times greater than the normal); 98 (76.5 %) of 128 blood samples from patients during a chronic phase had abnormally high PBIgG but the levels of IgG were generally lower than those observed in the acute phase; 75 (75 %) of 100 samples from patients in remission did not have pathologically increased PBIgG. Usually when the platelet count improved (after prednisone therapy or after splenectomy), PBIgG decreased. The PBIgG determination was not useful for predicting the response to prednisone therapy or the further evolution of the disease, except when PGIgG remained elevated after high-dose prednisone therapy; this generally implied a poor prognosis. PBIgG have also been found elevated in other diseases such as lupus erythematosus and in one case of chronic lymphocytic leukemia. This assay may be of a great clinical interest, especially for the diagnosis of ITP.

摘要

采用Dixon等人(1975年)开发的定量抗球蛋白消耗试验来测定血小板表面存在的IgG量(血小板结合IgG,即PBIgG)。正常血小板或因生成减少导致血小板减少症患者的血小板,其每血小板的IgG含量低于10×10⁻¹⁵克。对196例患者抽取的364份血样进行了研究;其中173例患有特发性血小板减少性紫癜;70例处于疾病急性期的患者中有65例(93%)PBIgG升高(值比正常高100倍);128例处于慢性期患者的血样中有98例(76.5%)PBIgG异常升高,但IgG水平通常低于急性期观察到的水平;100例缓解期患者的样本中有75例(75%)PBIgG没有病理性升高。通常当血小板计数改善时(泼尼松治疗后或脾切除术后),PBIgG会降低。除了大剂量泼尼松治疗后PGIgG仍升高的情况外,PBIgG测定对于预测泼尼松治疗反应或疾病的进一步发展并无用处;这通常意味着预后不良。在其他疾病如红斑狼疮以及1例慢性淋巴细胞白血病中也发现PBIgG升高。该试验可能具有很大的临床意义,尤其是对于特发性血小板减少性紫癜的诊断。

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