摘要
目的探讨抗血小板生成素(TPO)抗体及抗血小板生成素受体(c-mpl)抗体与系统性红斑狼疮(SLE)伴血小板减少的相关性。方法选取SLE伴血小板减少患者36例(A组)、无血小板减少患者26例(B组)和健康对照者11例(C组),应用酶联免疫吸附法(ELISA)分别检测血清中TPO、抗TPO抗体、抗c-mpl抗体水平,分析其与临床表现及实验指标之间的相关性。结果 (1)血清TPO在A组明显高于C组; SLE患者中抗TPO抗体总阳性率为41. 9%,抗TPO抗体在A组、B组和C组的阳性率分别为55. 6%、23. 1%和0,组间比较差异有统计学意义(P <0. 05),抗TPO抗体阳性率在A、B两组间差异有统计学意义(P <0. 05);抗TPO抗体阳性者较阴性者易出现皮疹(P <0. 05);抗体阴性者易出现抗核小体抗体(P <0. 05);抗体阴性组较抗体阳性组活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)均延长,差异有统计学意义(P <0. 05);抗TPO抗体阳性组和阴性组间血小板计数、血清TPO、补体C3及C4、红细胞沉降率(ESR)、C-反应蛋白(CRP)、抗双链DNA(ds-DNA)抗体阳性率、抗β2糖蛋白1(β2-GP1)及系统性红斑狼疮疾病活动指数(SLEDAI)评分差异均无统计学意义(P> 0. 05);(2) SLE患者中抗c-mpl抗体总阳性率为25. 8%,抗c-mpl抗体在A组、B组和C组的阳性率分别为25%、26. 9%和0,组间比较差异无统计学意义(P> 0. 05),抗c-mpl抗体阳性率在A、B两组间差异无统计学意义(P> 0. 05);抗c-mpl抗体阳性者较阴性者易出现皮疹(P <0. 05);(3) SLE血小板减少患者抗TPO抗体阳性率与抗c-mpl抗体呈正相关。结论血清抗TPO抗体在SLE血小板减少患者中升高,抗TPO抗体及抗c-mpl抗体可能在SLE血小板减少的发病机制中发挥作用。
Objective To investigate the correlation of anti-thrombopoietin(TPO)antibody and anti-thrombopoietin receptor(c-mpl)antibody with thrombocytopenia in systemic lupus erythematosus(SLE).Methods Serum samples from 36 SLE patients with thrombocytopenia(group A),26 SLE patients with normal platelet counts(group B)and 11 healthy controls(group C)were collected.Serum TPO,anti-TPO antibody and anti-c-mpl antibody were detected by enzyme-linked immuno sorbent assay(ELISA).Their correlation with the clinical manifestations and experimental parameters was analyzed.Results ①Serum TPO levels in group A was significantly higher than group C;Serum anti-TPO antibody in SLE patients was 41.9%,and serum anti-TPO antibody in group A,group B and group C were 55.6%,23.1%and 0,respectively.The difference among three groups was statistically significant(P<0.05);Serum anti-TPO antibody was significantly different between groups A and B(P<0.05);Patients with positive anti-TPO antibody were more likely to have skin rashes than those with negative one(P<0.05),while patients with negative anti-TPO antibody were prone to anti-nucleosome antibodies;Activated partial thromboplastin time(APTT)and prothrombin time(PT)of the antibody negative group were longer than that of the antibody positive group,the difference was statistically significant(P<0.05);There was no significant difference in platelet count,serum TPO,complement C3 and C4,erythrocyte sedimentation rate(ESR),C reactive protein(CRP),anti-double-stranded-DNA(anti-dsDNA)positive rate,anti-β2-glycoprotein 1(anti-β2-GP1)and systemic lupus erythematosus disease activity index(SLEDAI)scores between anti-TPO antibody positive group and negative group.②Serum anti-c-mpl antibody in SLE patients was 25.8%,and in group A,group B and group C were 25%,26.9%and 0,respectively.The difference among three groups was not statistically significant(P>0.05);Serum anti-c-mpl antibody was not significantly different between A and B groups(P>0.05);Patients with positive anti-c-mpl antibody were more likely to have skin rashes than those with negative one(P<0.05);③Serum anti-TPO antibody was positively correlated with serum anti-c-mpl antibody in SLE patients with thrombocytopenia.Conclusion Serum anti-TPO antibodies were elevated in SLE patients with thrombocytopenia,and anti-TPO antibody and anti-c-mpl antibody may play a role in the pathogenesis of SLE-associated thrombocytopenia.
作者
王维娟
方璇
厉小梅
汪国生
陶金辉
王钢
李向培
Wang Weijuan;Fang Xuan;Li Xiaomei(Dept of Rheumatology,The Affiliated Provincial Hospital of Anhui Medical University,Hefei 230001)
出处
《安徽医科大学学报》
CAS
北大核心
2018年第11期1785-1790,共6页
Acta Universitatis Medicinalis Anhui
基金
国家自然科学基金(编号:81373186)
