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目的分析糖皮质激素、环孢菌素A治疗无效的特发性血小板减少性紫癜(ITP)患者血小板相关免疫球蛋白(PAIg)的亚型。方法采用酶联免疫法(ELISA)对19992004年绵阳市中心医院收治的17例激素治疗无效、4例激素+环孢菌素A治疗无效以及30例激素治疗有效ITP患者的PAIg亚型进行检测。结果17例激素治疗无效的患者PAIg各亚型抗体较之激素治疗有效ITP患者差异有显著性(P<0·01),激素治疗无效组PAIg各亚型水平均明显增高;激素+环孢菌素A治疗无效组PAIgM较之激素治疗有效ITP患者有所增高(P<0·05)。结论激素治疗无效的ITP患者PAIg各亚型均显著增高,提示PAIg在介导ITP患者异常免疫反应过程中起重要作用,PAIg各亚型水平的增高可能有助于预测ITP患者对激素治疗的敏感性。
Objective To analyze the subtypes of platelet-associated immunoglobulin (PAIg) in patients with idiopathic thrombocytopenic purpura (ITP) who are treated with cyclosporin A and corticosteroids. Methods 17 cases of hormone therapy in Mianyang Central Hospital from 1999 to 2004 were invalidated by enzyme-linked immunosorbent assay (ELISA), PAIg subtype of 4 cases of hormone + cyclosporine A was invalid and 30 cases of hormone therapy-effective ITP were detected. Results There were significant differences in PAIg subtypes of antibodies between the 17 patients with and without hormone therapy (P <0.01), and the PAIg subtypes were significantly higher in patients with hormone ineffective therapy PAIgM was significantly higher in patients treated with hormone A than those treated with hormone therapy (P <0.05). Conclusions PAIg subtypes in ITP patients with inactive ITP are significantly increased, suggesting that PAIg plays an important role in mediating the abnormal immune response in patients with ITP. Elevated PAIg subtypes may be helpful in predicting the sensitivity of ITP patients to hormone therapy Sex.