Gratama J W, D'Amaro J, de Koning J, den Ottolander G J
Br J Haematol. 1984 Feb;56(2):287-93. doi: 10.1111/j.1365-2141.1984.tb03956.x.
The distribution of HLA-A, -B, -C and -DR antigens was investigated in 154 patients with immune thrombocytopenia (99 adults and 55 children). An increased frequency of HLA-Bw56 (a split of HLA-Bw22) was found both in the adults (RR = 4.30) as well as in the children (RR = 7.91). Differences in HLA antigen distributions have also been analysed in patient subgroups with a good and a bad response to corticosteroids and splenectomy. The frequency of HLA-DR4 was low in those patients with a good response to prednisone as compared with those with a poor response. The opposite was found in splenectomized patients. In 22 patients who did not respond to splenectomy, LB4 (a local split of HLA-DR4) was completely absent. These results suggest that HLA-DR4 (LB4) may be a predictive marker for therapy in ITP patients, i.e. a bad response to corticosteroids and a favourable outcome of splenectomy. However, none of the differences were significant after correction was made for the number of antigens tested.
对154例免疫性血小板减少症患者（99例成人和55例儿童）的HLA - A、- B、- C和 - DR抗原分布进行了研究。发现成人（相对危险度RR = 4.30）和儿童（RR = 7.91）中HLA - Bw56（HLA - Bw22的一个亚型）的频率均增加。还分析了对皮质类固醇和脾切除术反应良好及反应不佳的患者亚组中HLA抗原分布的差异。与反应不佳的患者相比，对泼尼松反应良好的患者中HLA - DR4的频率较低。脾切除术后患者的情况则相反。在22例对脾切除术无反应的患者中，完全不存在LB4（HLA - DR4的一个局部亚型）。这些结果表明，HLA - DR4（LB4）可能是ITP患者治疗的一个预测标志物，即对皮质类固醇反应不佳且脾切除术预后良好。然而，在对所检测的抗原数量进行校正后，这些差异均无统计学意义。
