摘要：
目的 对特发性血小板减少性紫癜(ITP)患者的核因子-κB(NF-κB)、幽门螺杆菌(Hp)、幽门螺杆菌细胞毒素相关蛋白A(CagA)、血小板(PLT)、血小板相关IgG抗体(PA-IgG)进行检测分析,探讨NF-κB、cagA在ITP发病机制中的作用,寻找改善ITP预后的方法.方法 SABC法检测NF-κB,C13尿素呼气试验(uBT)检测Hp,酶联免疫法测定外周血cagA、PA-IgG,全自动血细胞分析仪测定PLT.依据检测结果将患者分为Hp+cagA+NF-κB+、Hp+cagA+NF-κB-、Hp+cagA-NF-κB+、Hp+cagA-NF-κB-、Hp-NF-κB+、Hp-NF-κB-六组.对各组PA-IgG、PLT进行统计学分析.结果 224例ITP,Hp阳性175例,阳性率78.13%.175例Hp+,其中cagA+91例,Hp+中占52%,总体中占43.63%.NF-κB+共108例,总阳性率46.21%;其中Hp+cagA+中78例,阳性率85.71%;Hp+cagA-中21例,阳性率25%;49例Hp-中9例NF-κB+,占18.37%.分析各组PLT、PA-IgG,Hp+较Hp-组,Hp+cagA+较Hp+cagA-组,NF-κB+较NF-κB-组,PLT低、PA-IgG高,差异有统计学意义(P<0.05).结论 cagA可能直接或通过激活NF-κB参与免疫应答,致ITP患者PA-IgG升高,血小板降低.%Objective To detect and analyze nuclear factor kappa B (NF-κB),Helicobacter pylori (HP),Helicobacter pylori cytotoxin associated protein A (CagA),platelet (PLT) and platelet associated IgG (PA IgG) in 224 patients with idiopathic thrombocytopenic purpur(ITP) from three urban hospitals of Shaoxing,in order to explore the role of NF-κB and CagA in the pathogenesis of ITP,then to improve the prognosis of ITP.Methods SABC method was used to detect the NF-κB,13C breath test for the determination of the Hp infection.CagA and PA-IgG were tested by enzyme linked immunosorbent assay.Automatic blood cell analyzer was used to measure PLT.According to the test results,the patients were divided into Hp+cagA+NF-κB+,Hp+cagA+NF-κB-,Hp+cagA-NF-κB+,Hp+cagA-NF-κB-,Hp-NF-κB+,Hp-NF-κB-PLT groups,and PA-IgG,PLT of the six groups were statistically analyzed.Results Of 224 cases with ITP,175 cases of HP positive,the positive rate was 78.13%.CagA+ 91 cases in 175 cases of Hp+,accounting for 52%,overall 43.63%.NF-kappa B+ 108 cases,the positive rate was 46.21%,78 cases were found in Hp+cagA+,accounting for 85.71% in cagA+.In 84 cases of Hp+cagA-,there were 21 cases NF-κB+,the positive rate was 25%.In 49 of HP-,9 cases with NF-kappa B+,accounting for 18.37%.PLT and PA-IgG were compared among the groups.The count of PLT of group Hp+,group Hp+cagA+ and group NF-κB+ was lower than group Hp-,group Hp+cagA- and group NF-κB-.However,the level of PA-IgG of group Hp+,group Hp+cagA+ and group NF-κB+ was higher than group Hp-,group Hp+cagA- and group NF-κB-,the difference was statistically significant(P<0.05).Conclusion CagA maybe directly or through the activation of NF-kappa B take part in the immune response of ITP,cause PA-IgG increased and thrombocytopenia.
