血小板特异性抗体联合检测在免疫性血小板减少症鉴别诊断中的价值

摘要

目的：通过检测血小板减少症患者外周血B淋巴细胞血小板膜糖蛋白特异性抗体的变化，探讨其表达水平变化对血小板减少症鉴别诊断的临床意义。方法应用流式微球技术检测血小板减少症患者及健康对照者外周血GPⅡb／Ⅲa、GPⅠb／ⅠX的表达水平。结果原发IT P与继发IT P患者血小板特异性抗体GPⅡb／Ⅲa、GPⅠb／ⅠX与对照组比较差异有统计学意义（P＜0．05）；血小板特异性抗体GPⅠb／ⅠX诊断原发ITP的敏感度43％，特异度89％；GPⅡb／Ⅲa诊断原发ITP的敏感度86％，特异度83％。两者联合诊断敏感度90％，特异度83％。结论联合检测两种血小板抗体，提高原发ITP和SLE的诊断阳性率；GPⅠb／ⅠX在IT P中的诊断优势不如GPⅡb／Ⅲa。%Objective To detect the changes and clinical significance of the expression of anti‐GPⅡb/Ⅲa and anti‐GPⅠb/ⅠX on anti‐secreting B cells in patient with thrombocytopenia .Methods Expression of anti‐GPⅡb/Ⅲa and anti‐GPⅠb/ⅠX specific autoantibodies in thrombocytopenia were tested with (CBA) .Results There were significantly more circulating anti‐GPⅠ b/ⅠX and anti‐GPⅡb/Ⅲa antibody‐producing B cells in primary ITP(P<0 .05) for all comparisons .For diagnosing primary ITP ,the an‐ti‐GPⅠb/ⅠX had 43% sensitivity and 89% specificity ,whereas the anti‐GPⅡ b/Ⅲ a had 86% sensitivity and 83% specificity . When two tests were combined ,the sensitivity improved to 90% without a reduction in specificity .Conclusion The assay for detec‐ting anti‐GPⅠb/ⅠX is useful for identifying patients with ITP ,but its utility for diagnosing ITP is inferior to the anti‐GPⅡb/Ⅲa assay .