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目的 探索对自身免疫性血小板减少性紫癜 (AITP)诊断特异和敏感的实验方法。方法 采用单克隆抗体特异性俘获血小板抗原技术 (MAIPA技术 )并加以改进 ,对比检测血小板洗脱液和血浆中血小板膜糖蛋白特异性抗体。结果 AITP患者血浆游离抗血小板膜糖蛋白 (GPⅡb Ⅲa、GPⅠb Ⅸ )抗体总阳性率为 38.89%(5 4例中 2 1例 ) ,洗脱血小板表面抗血小板膜糖蛋白 (GPⅡb Ⅲa、GPⅠb Ⅸ )抗体总阳性率为 6 8.5 2 %(5 4例中 37例 ) ,两者差异有显著性 (校正 χ2 =19.39,P <0 .0 0 5 )。原发AITP组血浆游离及洗脱血小板表面抗血小板糖蛋白 (GPⅡb Ⅲa、GPⅠb Ⅸ )特异性抗体总阳性率与继发性AITP组比较差异无显著性。AITP患者血小板数量与自身抗体滴度呈明显负相关。结论 MAIPA法检测血小板洗脱液中抗血小板糖蛋白抗体在AITP的诊断和治疗中具有高度特异性 ,且敏感性较血浆抗体检测显著提高。
Objective To explore a specific and sensitive experimental method for the diagnosis of autoimmune thrombocytopenic purpura (AITP). Methods Monoclonal antibody specific capture platelet antigen technique (MAIPA technique) was used to improve the detection of platelet membrane glycoprotein specific antibody in platelet eluent and plasma. Results The total positive rate of plasma free anti-platelet glycoprotein (GPⅡb Ⅲa, GPⅠb Ⅸ) in AITP patients was 38.89% (21 cases in 54 cases). The platelet surface antiplatelet glycoprotein (GPⅡb Ⅲa, GPⅠb Ⅸ) The total positive rate of antibody was 6 8.52% (37 of 54 cases), the difference was significant (χ2 = 19.39, P <0.05). There was no significant difference in the total positive rate of the specific antibody of plasma free and eluted platelet anti-platelet glycoprotein (GPⅡb Ⅲa, GPⅠb Ⅸ) between the two groups in the primary AITP group and the secondary AITP group. AITP patients with platelet count and autoantibody titers showed a significant negative correlation. Conclusion The MAIPA assay of platelet eluent anti-platelet glycoprotein antibodies in the diagnosis and treatment of AITP has a high specificity, and the sensitivity was significantly higher than the plasma antibody test.