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目的 研究特发性血小板减少性紫癜 (ITP)患儿血小板生成调控因子的变化。方法 采用双抗体夹心酶联免疫吸附法 (ELISA)定量检测了 2 0 0 0年 1月至 2 0 0 1年 12月山东大学齐鲁医院儿科收治的 4 5例急性ITP患儿治疗前后血清和骨髓上清液中血小板生成素 (TPO)和转化生长因子 β1(TGF β1)水平。结果 ( 1)ITP患儿治疗前血清TPO水平高于正常对照组 ,但差异无显著性 ;治疗前TGF β1水平明显高于对照组 (P <0 0 1)。 ( 2 )经过激素治疗缓解后血清TPO水平较治疗前有所降低 ,但差异无显著性。治疗反应差者治疗前血清TPO水平较治疗反应好者显著升高 ( P <0 0 1) ,并高于对照组 ( P <0 0 1)。缓解后血清TGF β1水平与治疗前相比无明显下降 (P >0 0 5 )。 ( 3)治疗前骨髓上清液中TPO和TGF β1水平均高于对照组 (P <0 0 1) ,并明显高于同期血清水平 (P <0 0 1) ,且和血清中的TPO和TGF β1水平呈正相关。 ( 4 )ITP患儿血小板数目低时 ,TPO水平偏高 ;治疗后血小板数回升时 ,TPO水平有所降低 ,TPO水平与血小板数呈负相关 (r =- 0 6 4 9,P <0 0 5 ) ,同时和巨核细胞数也呈负相关 (r =- 0 5 19,P <0 0 5 )。结论 血清、骨髓上清液中TPO、TGF β1水平的检测可为ITP患儿的病情判断、估计预后、制定个体性治
Objective To study the changes of platelet-forming regulators in children with idiopathic thrombocytopenic purpura (ITP). Methods The serum and bone marrow of 45 children with acute ITP treated in Pediatrics Department of Qilu Hospital of Shandong University from January 2000 to December 2001 were measured quantitatively by double antibody sandwich enzyme-linked immunosorbent assay (ELISA) Supernatant of thrombopoietin (TPO) and transforming growth factor β1 (TGF β1) levels. Results (1) The level of serum TPO in children with ITP before treatment was higher than that in the normal control group, but the difference was not significant. The level of TGF-β1 in children with ITP before treatment was significantly higher than that in the control group (P <0.01). (2) The level of serum TPO after hormone therapy was relieved was lower than that before treatment, but the difference was not significant. Patients with poor response to treatment had significantly higher serum TPO levels than those with good response (P <0.01), and higher than those in the control group (P <0.01). After remission, the level of serum TGFβ1 was not significantly lower than that before treatment (P> 0.05). (3) The levels of TPO and TGFβ1 in bone marrow supernatants before treatment were higher than those in control group (P <0.01), and were significantly higher than those in the same period (P <0.01) TGF β1 level was positively correlated. (4) When the number of platelets in children with ITP was low, the level of TPO was high. When the number of platelets increased after treatment, the level of TPO decreased and the level of TPO was negatively correlated with the number of platelets (r = - 0.649, P <0 0 5), and negatively correlated with the number of megakaryocytes (r = - 0 5 19, P <0 05). Conclusion The detection of TPO and TGFβ1 in serum and bone marrow supernatant can be used to judge the condition of ITP children, to estimate the prognosis and to develop individual treatment