贵州医科大学学报

2014, v.39;No.171(06) 858-860+864

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血小板特异性抗体对特发性血小板减少性紫癜的诊断价值
Diagnostic Value of Platelet-specific Antibodies in Idiopathic Thrombocytopenic Purpura Patients

刘景珍;
LIU Jingzhen;Department of Pediatrics,Enshi Central Hospital;

摘要(Abstract):

目的:探讨血小板特异性抗体(PAIg)对特发性血小板减少性紫癜(ITP)的诊断价值。方法:应用改良单克隆特异性抗体俘获血小板(MAIPA)技术检测35例ITP患者(ITP组)、32例慢性障碍再生贫血(CAA)患者(CAA组)、30例恶性血液疾病患者(恶性血液病组)以及30例健康体检者(健康对照组)的血小板特异性抗体GPⅠV、GPV、GPIb/ⅠX及GPⅡb/Ⅲa抗体阳性率,并比较4种抗体的敏感性、特异性、阳性预测值和阴性预测值。结果:ITP组、CAA组、恶性血液疾病组以及正常对照组4种抗体的阳性率分别为91.43%、15.63%、10.00%及0.00%,ITP组特异性抗体阳性率明显高于其余3组,CAA组与恶性血液病组明显高于对照组,差异有统计学意义(P<0.05);GPⅠV、GPV、GPIb/ⅠX、GPⅡb/Ⅲa联合检测时的敏感性、特异性、阳性预测值以及阴性预测值明显高于与单一抗体检测,差异有统计学意义(P<0.05)。结论:PAIg可鉴别ITP与非免疫性血小板减少疾病,并作为ITP诊断的特异性指标。
Objective: To investigate the diagnostic value of platelet-specific antibodies( PAIg) in idiopathic thrombocytopenic purpura( ITP) patients. Methods: The positive rates of antibodies( GPⅠ V,GPV,GPIb /ⅠX and GPⅡ b /Ⅲa) of 35 ITP patients( ITP group),32 patients of chronic obstructive regenerative anemia( CAA)( CAA group),30 patients of malignant blood disease( MBD group) and 30 healthy people( control group) were detected by modified monoclonal antibodies to capture platelet( MAIPA) technique. Sensitivity,specificity,positive and negative predictive values of the four antibodies were compared. Results: The positive rates of four antibodies of ITP group,CAA group,MBD group and the control group were 91. 43%,15. 63 %,10. 00% and 0. 00% respectively. The specific antibody positive rate of ITP group was higher than that of the other three groups,while the specific antibody positive rates of CAA and MBD group were higher than that of control group( P < 0. 05). The sensitivity,specificity,positive predictive value,negative predictive value of GPⅠ V,GPV,GPIb / ⅠX,GP Ⅱb / Ⅲ joint detection were higher than those of the single antibody test( P < 0. 05). Conclusions: PAIg can effectively identify ITP and non-immune thrombocytopenia diseases,it can serve as a specific index for diagnosis of ITP.

关键词(KeyWords): 紫癜,血小板减少性,特发性;抗体,单克隆;血小板;血液病;敏感性与特异性;诊断
purpura,thrombocytopenic,idiopathic;antibodies,monoclonal;platelets;blood diseases;sensitivity and specificity;diagnosis

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作者(Author): 刘景珍;
LIU Jingzhen;Department of Pediatrics,Enshi Central Hospital;

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