Kunishima S, Kobayashi S, Takagi A, Naoe T, Ohno R
Department of Central Clinical Laboratory, Meijo Hospital, Nagoya, Japan.
Am J Clin Pathol. 1993 Nov;100(5):579-84. doi: 10.1093/ajcp/100.5.579.
To aid in the rapid differential diagnosis of thrombocytopenia, the authors developed a latex agglutination test for glycocalicin, a proteolytic fragment of platelet membrane glycoprotein Ib. Plasma glycocalicin determinations were performed for 34 patients with thrombocytopenia. Plasma samples from four patients with aplastic anemia and ten patients with myelodysplastic syndromes, all with glycocalicin levels less than 0.6 mg/L by an enzyme-linked immunosorbent assay, all had negative results by the latex test. In contrast, positive latex agglutination titers were obtained for all 12 patients with idiopathic thrombocytopenic purpura. Eight patients with liver cirrhosis and splenomegaly had elevated levels of plasma glycocalicin, and all of their plasma samples produced agglutination. This latex agglutination test for glycocalicin allows a rapid discrimination of thrombocytopenia caused by impaired platelet production from that caused by increased platelet destruction; thus, it is suitable for use as a screening test in a routine clinical laboratory.
为了有助于血小板减少症的快速鉴别诊断，作者研发了一种针对糖萼蛋白的乳胶凝集试验，糖萼蛋白是血小板膜糖蛋白Ib的蛋白水解片段。对34例血小板减少症患者进行了血浆糖萼蛋白测定。通过酶联免疫吸附测定法，4例再生障碍性贫血患者和10例骨髓增生异常综合征患者的血浆样本糖萼蛋白水平均低于0.6mg/L，乳胶试验结果均为阴性。相比之下，12例特发性血小板减少性紫癜患者的乳胶凝集效价均为阳性。8例肝硬化伴脾肿大患者的血浆糖萼蛋白水平升高，其所有血浆样本均产生凝集。这种针对糖萼蛋白的乳胶凝集试验能够快速区分血小板生成受损引起的血小板减少症和血小板破坏增加引起的血小板减少症；因此，它适合作为常规临床实验室的筛查试验。
