摘要
目的分析干燥综合征(primary Sj gren's syndrome,PSS)患者抗血小板生成素(thrombopoietin;TPO)受体(cmpl)抗体与血小板减少的相关性和作用,探讨抗体的致病机制和临床意义。方法选取PSS伴有血小板减少患者40例(A组)、无血小板减少患者40例(B组),以及同期住院的抗磷脂综合征(antiphospholipid syndrome,APS)患者40例(C组)、无血小板减少的系统性红斑狼疮(systemic lupus erythematosus,SLE)患者24例(D组)、正常体检的健康志愿者40例(E组),应用酶联免疫吸附法(enzyme-linked immuno sorbent assay,ELISA)检测血清TPO水平;间接ELISA法测定抗c-mpl抗体水平,分析其与临床表现、指标之间的相关性和意义。结果①血清抗c-mpl抗体在A、B、C、D和E组中的检出率分别为62.5%、27.5%、12.5%、12.5%和0,组间比较差异有统计学意义(P<0.001);单独比较A组与B组血清抗c-mpl抗体及血清TPO水平差异均有统计学意义(P值分别为0.001和0.004)。②PSS患者抗c-mpl抗体与抗SSA抗体具有相关性(P<0.05),与ESR、IgG、IgA水平呈线性正相关(P<0.05),与血小板计数负相关(r=-0.32,P=0.004),与骨髓增生分化无相关性,而与巨核细胞成熟障碍、骨髓血小板生成减少相关(P<0.05)。结论抗c-mpl抗体可能与PSS血小板减少相关,骨髓巨核细胞成熟障碍血小板产量减少可能是抗c-mpl抗体致病作用途径。
Objective To investigate the relationship between anti-thrombopoietin receptor（c-Mpl） auto-antibody and throm- bocytopenia in patients with primary Sj gren＇s syndrome（ PSS）, and explore the pathogenic mechanism and clinical significance of this antibody. Methods Serum samples from 40 PSS patients with thrombocytopenia（ group A） ,40 PSS patients with normal platelet counts （group B ） ,40 patients with antiphospholipid syndrome （group C ） ,24 systemic lupus erythematosus （SLE）patients with normal platelet counts（ group D）and 40 healthy controls（ group E）were collected. Anti c-Mpl antibodies were detected by using an indirect ELISA assay and serum TPO levels were measured by an ELISA assay. The relationship and significance between the clinical manifestations and parameters with this antibody were analyzed. Results Serum anti c-Mpl antibody in the group A, B, C, D and E were 62. 5 % ,27.5%, 12. 5 %, 12. 5 % and 0, respectively. The differences were statistically significant （P 〈 0. 001 ）. The differences in serum anti c-Mpl anti-body and serum level of TPO between the group A and B group were statistically significant（ P= 0. 001 and 0. 004, respectively）. The anti c-Mpl antibody of the PSS patients was positively correlated with ESR, IgG, IgA,β2-GP1 and the SSA antibody （P 〈 0. 05 ）, but negatively correlated with platelct count （r =-0. 32, P = 0. 004）. Anti c-Mpl antibody was not correlated with bone marrow proliferation and differentiation,but correlated with the megakaryocyte maturation disorder and decreased platelet production. Conclusion Anti c- MpI antibody may be associated with thrombocytopenia in patients with PSS. Decreased platelet production due to bone marrow megakaryocyte maturation disorder may be a pathogenic mechanism of this antibody..
出处
《实用医院临床杂志》
2014年第2期63-66,共4页
Practical Journal of Clinical Medicine
基金
四川省卫生厅科研基金资助项目(编号:120069)
