Abstract
目的研究原发免疫性血小板减少症（ITP）患者血小板活化状态和出血程度的相关性。方法采用ITP特异性出血评价工具（ITP-BAT）对43例ITP患者进行出血评分及出血程度分级，应用流式细胞术检测二磷酸腺苷（ADP）激活前后血小板膜糖蛋白（GP）Ⅰb、Ⅱb/Ⅲa和P选择素表达。分析GPⅠb、GPⅡb/Ⅲa、P选择素表达与血小板计数、未成熟血小板比例的相关性；分析GPⅠb、GPⅡb/Ⅲa、P选择素表达与ITP患者出血程度的相关性，以及对中度以上出血患者风险评估的应用价值。结果ITP患者激活前血小板GPⅡb/Ⅲa、P选择素表达均高于正常对照组（65.69±10.73对7.16±0.99，t=4.130，P<0.001；15.43±1.41对12.55±1.03，t=2.070，P=0.043），GPⅠb表达低于正常对照组（240.11±24.93对295.11±22.15，t=2.417，P=0.020）。ITP患者ADP激活后血小板GPⅡb/Ⅲa表达高于正常对照组（133.96±12.17对39.67±4.99，t=5.256，P<0.001），而P选择素、GPⅠb表达低于正常对照组（37.09±3.94对109.77±23.66，t=3.901，P<0.001；149.06±19.14对205.73±21.00，t=2.070，P=0.043）。ADP激活后GPⅠb表达、ADP激活前后P选择素表达及ADP激活前后GPⅠb、P选择素表达比值与血小板计数相关（P<0.05）。ADP激活后P选择素表达、ADP激活前后P选择素表达比值与未成熟血小板比例相关（P<0.05）。ITP患者ADP激活后GPⅠb表达、ADP激活前后P选择素表达及ADP激活前后P选择素、GPⅡb/Ⅲa、GPⅠb表达比值在不同出血程度之间差异有统计学意义（P<0.05）。ADP激活前后GPⅠb表达比值是ITP患者中度以上出血的正性影响因素（OR=3.05，P=0.011），ADP激活前后P选择素、GPⅡb/Ⅲa表达比值是ITP患者中度以上出血的负性影响因素（OR=0.32，P=0.023；OR=0.04，P=0.006）。结论血小板活化指标能较准确地评估ITP患者出血程度，可以作为治疗参考指标和疗效观察指标。
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
