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目的探讨儿童急性特发性血小板减少性紫癜(AITP)与EBV感染的关系。方法用酶联免疫吸附法(ELISA)测定87例AITP患儿病毒特异性抗体EBV-IgM,做骨髓巨核细胞、外周血小板以及外周血异形淋巴细胞计数,采用改良MAIPA法检测血小板特异性抗体(GPIIb/IIIa)。对照组为40例健康体检的儿童。用统计学分析软件包SPSS13.0进行统计学分析。结果 87例AITP患儿中,EBV-IgM阳性者21例,阳性率24.14%,明显高于对照组(P<0.01)。AITP患儿EBV阳性组的外周血异形淋巴细胞数、血小板抗GPIIb/IIIa抗体阳性率均明显高于EBV阴性组(P<0.01)。而AITP患儿EBV阳性组的骨髓巨核细胞数和外周血小板数与EBV阴性组相比差异无显著性(P>0.05)。结论 EBV感染确实与部分儿童AITP的发病有关。EBV感染引起ITP的机制可能与引发机体自身免疫反应有关。
Objective To investigate the relationship between childhood acute idiopathic thrombocytopenic purpura (AITP) and EBV infection. Methods Enzyme-linked immunosorbent assay (ELISA) was used to determine the viral-specific antibody EBV-IgM in 87 children with AITP. The counts of bone marrow megakaryocytes, peripheral platelets and peripheral blood lymphocytes were measured. The modified platelet-specific antibody (GPIIb / IIIa). The control group was 40 healthy children. Statistical analysis software package SPSS13.0 was used for statistical analysis. Results Among 87 AITP children, 21 were positive for EBV-IgM, the positive rate was 24.14%, which was significantly higher than that of the control group (P <0.01). The number of abnormal peripheral blood lymphocytes and platelet anti-GPIIb / IIIa antibody positive rate in EBV-positive group were significantly higher than that in EBV-negative group (P <0.01). However, there was no significant difference in the number of bone marrow megakaryocytes and the number of peripheral platelets in EBV-positive AITP-treated children compared with EBV-negative patients (P> 0.05). Conclusion EBV infection is indeed associated with the onset of AITP in some children. The mechanism of ITP caused by EBV infection may be related to triggering the autoimmune reaction of the body.