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目的分析血小板生成素(TPO)及其抗体与原发性干燥综合征(PSS)患者血小板减少的相关性。方法选取2013年9月-2014年10月伴有血小板减少的PSS患者40例(A组)、曾有血小板减少已恢复正常的PSS患者22例(B组)、无血小板减少的PSS患者40例(C组),以及同期正常体检的健康志愿者40例(D组),应用酶联免疫吸附法(ELISA)检测血清TPO水平,间接ELISA法测定抗TPO抗体水平,分析其与临床表现、指标之间的相关性和意义。结果 A组TPO(129.74±17.47)pg/m L,B组TPO(330.23±18.07)pg/m L,C组TPO(364.19±12.25)pg/m L,均高于D组[(54.04±10.71)pg/m L],组间差异有统计学意义(P<0.05);TPO与C反应蛋白、免疫球蛋白A水平呈正相关(rs=0.224,P=0.039;rs=0.239,P=0.033),与补体C4水平呈负相关(rs=-0.220,P=0.041),与血小板计数、红细胞沉降率、抗磷脂抗体水平以抗核抗体滴度无相关性(P>0.05)。PSS患者抗TPO抗体阳性率为20.59%(21/102),A、B、C组分别为17.5%(7/40)、22.7%(5/22)、22.5%(9/40),组间差异无统计学意义(P>0.05),抗TPO抗体阳性组与阴性组组间各临床指标差异无统计学意义(P>0.05)。结论抗TPO抗体可能不是PSS血小板减少的主要发病机制,TPO与炎症因子有一定相关性。
Objective To analyze the correlation between thrombopoietin (TPO) and its antibody and thrombocytopenia in patients with primary Sjogren’s Syndrome (PSS). Methods Forty patients (group A) with PSS who had thrombocytopenia between September 2013 and October 2014 were enrolled. Twenty-two PSS patients (group B), who had thrombocytopenia returned to normal, and 40 patients without thrombocytopenia (Group C), and 40 healthy volunteers (group D) were enrolled in the same period. Serum TPO level was measured by enzyme-linked immunosorbent assay (ELISA) and anti-TPO antibody level by indirect ELISA. The correlations with clinical manifestations, The relevance and meaning between. Results The TPO in group A was (129.74 ± 17.47) pg / m L, that in group B was (330.23 ± 18.07) pg / m L, and that in group C was 364.19 ± 12.25 pg / m L (p <0.05). There was a positive correlation between TPO and C-reactive protein and immunoglobulin A (rs = 0.224, P = 0.039; rs = 0.239, P = 0.033) (Rs = -0.220, P = 0.041). There was no correlation between platelet count, erythrocyte sedimentation rate, antiphospholipid antibody level and antinuclear antibody titers (P> 0.05). The positive rates of anti-TPO antibodies in PSS patients were 20.59% (21/102), 17.5% (7/40), 22.7% (5/22) and 22.5% (9/40) in groups A, B and C respectively There was no significant difference between the two groups (P> 0.05). There was no significant difference in each clinical index between anti-TPO antibody positive group and negative group (P> 0.05). Conclusion The anti-TPO antibody may not be the main pathogenesis of PSS thrombocytopenia. TPO has some correlation with inflammatory cytokines.