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目的探讨儿童免疫性血小板减少症(ITP)起病初期血小板相关抗体检测结果与治疗反应的关系。方法选择我科2010年10月至2012年4月间收治的初发ITP患儿137例作为研究对象,于发病后治疗前采集外周血,经ELISA检测血小板相关抗体PAIgG、PAIgA、PAIgM,经儿童ITP一线方案治疗,评价患儿情况并观察至发病后12个月,将治疗反应分为有效和无效两组。对比两组患儿发病时血小板相关抗体数值,分析发病时血小板相关抗体值与治疗反应的关系。结果入组患儿中男78例(56.9%),女59例(43.1%),男女比例为1.32∶1,经治疗后有效率为75.9%,24.1%无效或转为慢性ITP,经检测血小板相关抗体后PAIgA、PAIgM、PAIgG三项,高于正常者分别为22例、70例、41例,占16.1%、51.1%、29.9%,有效组与无效组患儿均有血小板抗体升高,采用卡方检验三项血小板抗体增高与治疗反应之间的关系,血小板相关抗体增高对预测ITP的治疗反应无显著性差异(P>0.05),即血小板相关抗体的升高对预测ITP的治疗反应无明显作用。结论初发ITP患儿的血小板相关抗体增高与否对预测其远期疗效无明显指导意义。
Objective To investigate the relationship between the detection of platelet-associated antibodies in early onset of childhood immune thrombocytopenia (ITP) and the response to treatment. Methods A total of 137 newly diagnosed ITP patients admitted to our department between October 2010 and April 2012 were enrolled in this study. Peripheral blood was collected before the onset of the disease, and platelet-associated antibodies PAIgG, PAIgA and PAIgM were detected by ELISA. ITP first-line treatment, evaluation of children and observed until after onset of 12 months, the treatment response is divided into two groups of effective and ineffective. The incidence of platelet-related antibodies in two groups was compared, and the relationship between platelet-associated antibody levels and treatment response was analyzed. Results There were 78 males (56.9%) and 59 females (43.1%) with a male / female ratio of 1.32:1. The effective rates were 75.9%, 24.1% were ineffective or converted to chronic ITP. The detected platelets PAIgA, PAIgM and PAIgG were higher than those in the normal group (22 cases, 70 cases and 41 cases, accounting for 16.1%, 51.1% and 29.9%, respectively). The levels of platelet antibodies in both effective and non-effective groups were elevated, Using chi-square test to detect the relationship between the three platelet antibodies and the response to treatment, platelet-associated antibodies increased the predicted response to ITP no significant difference (P> 0.05), that platelet-related antibodies to predict the response to ITP treatment No significant effect. Conclusion Initial platelet-related antibodies in children with ITP or not to predict the long-term efficacy of no significant guiding significance.