【摘要】 目的:探究免疫性血小板减少症(immune thrombocytopenia, ITP)患者血小板抗体呈阳性的影响因素，明确血小板抗体呈阳性的影响因素在临床诊断中的意义及机制。方法:回顾性分析2021年1月—2024年12月医院确诊为ITP的289例住院患者的病例资料，其中男131例，女158例，根据血小板抗体检测结果分为阳性组(251例)与阴性组(38例),分别对比两组资料和T淋巴细胞群、抗核抗体(antinuclear antibodies, ANA);抗甲状腺过氧化物酶抗体检测(thyroid peroxidase antibody, TPOAb)和直接抗人球蛋白试验(direct antiglobulin tes, DAT)。结果:289例患者中，两组年龄与有无输血史对血小板抗体阳性率比较差异有统计学意义(P<0.05);继发性ITP中风湿免疫、系统性红斑狼疮和妊娠期血小板减少的血小板抗体阳性率要高于其他病症，差异有统计学意义(P<0.05);T淋巴细胞群(CD3~+、CD4~+和CD8~+)的水平变化、血清ANA、DAT和TPOAb是否呈阳性比较差异有统计学意义(P<0.05),且经过logistic回归分析均为血小板抗体阳性的独立危险因素(P<0.05)。结论:年龄、有无输血史、继发性ITP疾病类型、T淋巴细胞群的水平变化、血清ANA、DAT和TPOAb是否呈阳性是血小板抗体阳性的影响因素。更多还原

【Abstract】 Objective: Explore the influencing factors of platelet antibody positivity in patients with immune thrombocytopenia, and clarify the significance and mechanism of the influencing factors of platelet antibody positivity in clinical diagnosis. Methods: Adopting a retrospective research method. Select the medical records of 289 hospitalized patients diagnosed with ITP at our hospital between January 2021 and December 2024, including 131 males and 158 females. According to the platelet antibody test results, they are divided into positive and negative groups, and the data of the two groups are compared with T lymphocyte population(T-lymphocyte) and antinuclear antibodies(ANA), respectively; Thyroid peroxidase antibody(TPOAb) detection and direct anti human globulin test(DAT). Results: Among 289 patients, there was a statistically significant difference(P<0.05) in the positive rate of platelet antibodies between the two groups based on age and history of blood transfusion; The positive rate of platelet antibodies in rheumatic immunity, systemic lupus erythematosus, and pregnancy thrombocytopenia is higher in secondary immune thrombocytopenia than in other diseases, and the difference is statistically significant(P<0.05); The changes in the levels of T lymphocyte populations(CD3~+, CD4~+, and CD8~+), as well as the positivity of serum ANA, DAT, and TPOAb, showed statistically significant differences(P<0.05), and logistic regression analysis showed that they were all independent risk factors for platelet antibody positivity(P<0.05). Conclusion: Age, history of blood transfusion, type of secondary immune thrombocytopenia, changes in T lymphocyte levels, and positivity of serum ANA, DAT, and TPOAb are influencing factors for platelet antibody positivity.更多还原