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目的:通过检测晚期血吸虫病患者血小板相关抗体水平,分析血小板相关抗体在晚期血吸虫病治疗中的作用,为晚期血吸虫病并发血小板减少的治疗寻找新方法。方法:检测198例晚期血吸虫病患者(血小板减少者51例,血小板正常者147例),22例特发性血小板减少性紫癜患者,38例血小板减少症患者血小板相关抗体并进行比较。结果:晚期血吸虫病患者中血小板减少组血小板相关抗体IgGI、gM水平低于特发性血小板减少性紫癜组(P<0.05),而高于晚期血吸虫病血小板正常组和血小板减少症组(P<0.01或P<0.05)。晚期血吸虫病血小板正常组血小板相关抗体阳性率为27.27%,晚期血吸虫病血小板减少组为23.24%,均明显低于特发性血小板减少性紫癜组58.33%(P<0.05)。结论:晚期血吸虫病患者血小板减少并非单纯巨大脾脏所引起,是血吸虫卵刺激机体产生血小板相关抗体与血小板结合后在脾脏被破坏所致。
Objective: To detect the level of platelet-related antibodies in patients with advanced schistosomiasis, analyze the role of platelet-associated antibodies in the treatment of advanced schistosomiasis, and find a new method for the treatment of advanced schistosomiasis with thrombocytopenia. Methods: 198 patients with advanced schistosomiasis (thrombocytopenia in 51 cases, 147 cases of normal platelets), 22 cases of idiopathic thrombocytopenic purpura patients, 38 cases of thrombocytopenia in patients with platelet-related antibodies and compared. Results: Serum IgGI and gM levels of platelet-associated antibodies in patients with advanced schistosomiasis were lower than those in idiopathic thrombocytopenic purpura patients (P <0.05), but higher than those in patients with advanced schistosomiasis patients with normal platelets and thrombocytopenia group (P < 0.01 or P <0.05). The positive rate of platelet-associated antibody in the platelet-normal group was 27.27% in advanced schistosomiasis patients and 23.24% in advanced schistosomiasis patients, which were all significantly lower than those in idiopathic thrombocytopenic purpura patients (58.33%, P <0.05). Conclusion: Thrombocytopenia in patients with advanced schistosomiasis is not caused by a single giant spleen, but is caused by the destruction of spleens after the platelet-associated antibodies produced by Schistosoma japonicum eggs stimulate the body to produce platelets.