摘要
目的检测特发性血小板减少性紫癜(ITP)与非免疫性血小板减少症(Non-ITP)患儿血浆中血小板膜糖蛋白特异性抗体,评价该法在ITP与Non-ITP患儿中的诊断与鉴别诊断的价值。方法用改良单克隆抗体特异性俘获血小板抗原技术,检测ITP与Non-ITP患儿抗血小板GPⅡbⅢ/a和抗GPⅠbⅨ/的特异性抗体;酶联免疫吸附竞争法检测其血小板相关抗体(PAIgG),对二种方法所测结果进行比较。结果ITP患儿血浆中抗GPⅡbⅢ/a的特异性抗体阳性率为47.4%,抗GPⅠbⅨ/的特异性抗体阳性率为22.8%,抗GPⅡbⅢ/a和抗GPⅠbⅨ/同时阳性为15.8%,总阳性率54.4%,且多数为GPⅡbⅢ/a抗体;其中,慢性ITP患儿血浆中抗GPⅡbⅢ/a和抗GPⅠbⅨ/特异性抗体总阳性率为66.7%,略高于急性ITP患儿;Non-ITP患儿血浆中仅抗GPⅡbⅢ/a抗体阳性率为20.0%,抗GPⅠbⅨ/抗体未检出,与ITP比较有显著性差异(P<0.01);PAIgG检测ITP患儿阳性率为84.2%,Non-ITP患儿阳性率为75.0%,二者比较无显著性差异(P>0.05);特异性抗体检测诊断ITP的灵敏度为54.4%,特异度为80.0%,阳性预测值为88.6%。结论抗血小板特异性抗体检测对于鉴别诊断ITP与Non-ITP有一定的临床意义。
Objective To evaluate the clinical significance of platelet glycoprotein-specific antibody detection in the differential diagnosis between idiopathic thrombocytopenic purpura（ITP） and nonimmune thrombocytopenia（Non-ITP）.Methods Anti-GPⅡb/Ⅲa and anti-GPⅠb/Ⅸ antibodies were detected by a modified monoclonal antibody immobilization of platelet antigens assay,and the platelet-associated IgG（PAIgG） was measured by enzyme linked immunosorbent assay,and the 2 assays were compared.Results The positive rate of specific anti-GPⅡb/Ⅲa and anti-GPⅠb/Ⅸ antibodies were 47.4% and 22.8%,and the positive rate of both anti-GPⅡb/Ⅲa and anti-GPⅠb/Ⅸ antibodies were 15.8%,and the total positive rate was 54.4%,and anti-GPⅡb/Ⅲa were much more than anti-GPⅠb/Ⅸ.Compared with acute ITP patients,chronic ITP patients had slightly higher rate of anti-GPⅡb/Ⅲa and anti-GPⅠb/Ⅸ antibodies,and the positive rate was 66.7%.The positive rate of anti-GPⅡb/Ⅲa antibodies in Non-ITP was 20%,while none of the anti-GPⅠb/Ⅸ was detected,which had significant difference compared with ITP patients（P〈0.01）.The positive rate of ITP patients was 84.2% while Non-ITP was 75.0%.There was no significant difference between ITP and Non-ITP patients in PAIgG（P〉0.05）.The sensitivity of ITP diagnosis by specific antibody was 54.4%,the peculiarity was 80.0%,and the positive predictive value was 88.6%.Conclusion The platelet glycoprotein-specific antibody detection has certain clinical significance in discriminating ITP from Non-ITP.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2008年第15期1179-1180,1182,共3页
Journal of Applied Clinical Pediatrics
关键词
血小板减少性紫癜
糖蛋白
抗体
诊断
儿童
thrombocytopenic purpura
glycoprotein
antibody
diagnosis
child
