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目的 用流式细胞术 (FCM)检测血小板自身抗体 ,评价FCM在免疫性血小板减少症诊断中的应用价值。方法 采用FCM和竞争性ELISA方法 ,检测了 81例血小板减少症患者及 3 1名正常志愿者血小板表面的血小板相关免疫球蛋白G(PAIgG) ,并将两种方法的结果作了比较。结果 以FCM检测PAIgG ,5 1例特发性血小板减少性紫癜 (ITP)患者的血小板阳性百分率 ( 4 4.5± 2 7.7) %和相对平均荧光强度 (相对MFI) 9.3 5± 12 .2 2均明显高于正常对照组 [血小板阳性百分率 ( 16.6± 8.4 ) %(P <0 .0 1) ,相对MFI 2 .16± 0 .76(P <0 .0 1) ],亦高于再障、阵发性睡眠性血红蛋白尿患者 [血小板阳性百分率 ( 18.4± 9.5 ) % (P <0 .0 1) ,相对MFI 2 .64± 1.74 (P <0 .0 5 ) ];16例系统性红斑狼疮 (SLE)、淋巴瘤、多发性骨髓瘤和急性粒细胞白血病患者的结果 [血小板阳性百分率 ( 3 7.5± 2 2 .6) % (P <0 .0 1) ,相对MFI 6.2 0± 6.66(P <0 .0 5 ) ]也明显高于正常对照组 ;此外 ,13 /5 1例ITP和 2 /11例SLE患者的荧光直方图中出现显著的峰形改变。FCM检测ITP的阳性率 ( 86.3 % )比ELISA法 ( 82 4 % )略高 (P >0 0 5 )。结论 FCM用于免疫性血小板减少症患者PAIgG的检测 ,具有灵敏、快速、简单和客观的特点 ,是适用于临床诊断的?
Objective To detect the platelet autoantibodies by flow cytometry (FCM) and evaluate the value of FCM in the diagnosis of immune thrombocytopenia. Methods Platelet-associated immunoglobulin G (PAIgG) was detected on platelet surface in 81 thrombocytopenic patients and 31 normal volunteers by FCM and competitive ELISA. The results of two methods were compared. Results The percentage of platelet positive (45.5 ± 2 7.7%) and relative mean fluorescence (relative MFI) in 51 patients with idiopathic thrombocytopenic purpura (ITP) were all significantly higher Higher than the normal control group [platelet positive percentage (16.6 ± 8.4)% (P <0.01), relative MFI 2.16 ± 0.76 (P <0.01), also higher than aplastic anemia The percentage of platelet positive patients (n = 18.4 ± 9.5)% (P <0.01), relative MFI 2.64 ± 1.74 (P <0.05); 16 patients with systemic lupus erythematosus SLE), lymphoma, multiple myeloma, and acute myeloid leukemia [platelet positive percentage (3 7.5 ± 2.2 2)% (P 0 01), relative MFI 6.2 0 ± 6.66 (P < 0.05) was also significantly higher than the normal control group; in addition, 13/51 cases of ITP and 2/11 cases of SLE patients showed significant changes in the fluorescence histogram. The positive rate of FCM in detecting ITP (86.3%) was slightly higher than that in ELISA (82.4%) (P> 0.05). Conclusions FCM is a sensitive, rapid, simple and objective method for detecting PAIgG in patients with immune thrombocytopenia and is suitable for clinical diagnosis.