【摘要】 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?更多还原

【Abstract】 Objective To determine the autoantibody against platelet by flow cytometry (FCM), and evaluate the value of FCM in the diagnosis of immune thrombocytopenia. Method By FCM and a competitive enzyme linked immunosorbent assay (ELISA), platelet associated immunoglobulin G (PAIgG) on the platelets was measured in samples from 81 patients with thrombocytopenia and 31 normal volunteers The results obtained from these two methods were compared Results The levels of percentage positive platelets (44 5±27 7)% and relative mean fluorescence intensity (relative MFI) 9 35±12 22 measured by FCM analysis, obtained in 51 patients with idiopathic thrombocytopenic purpura (ITP), were markedly higher than in control subjects [percentage positive platelets (16 6±8 4)% ( P <0 01), relative MFI 2 16±0 76 ( P <0 01)], and higher than in patients with aplastic anemia or paroxysmal nocturnal hemoglobinuria [percentage positive platelets (18 4± 9 5)% ( P <0 01), relative MFI 2 64±1 74 ( P <0 05)] as well And the data in 16 patients with systemic lupus erythematosus (SLE), lymphoma, multiple myeloma and chronic myelocytic leukemia [percentage positive platelets (37 5±22 6)% ( P <0 01), relative MFI (6 20±6 66) ( P <0 05)] were also markedly higher than in control subjects In addition, noteworthy change of peak shape appeared in the histogram of fluorescence intensity (log) in 13out of 51 patients with ITP and 2 out of 11 cases with SLE The positive percentage of FCM analysis in ITP (86 3%) was lightly higher ( P >0 05) than the positive percentage of ELISA (82 4%) Conclusion FCM measurement may be characterized by high sensitivity, rapidity, simplicity and objectivity for the determination of PAIgG in the patients with immune thrombocytopenia It is a novel and applicable method to clinical diagnosis It has a potential value in enhancing the diagnostic level of immune thrombocytopenia and giving a guide to treatment更多还原