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目的探讨血栓性血小板减少性紫癜(thrombotic thrombocytopenic purpura,TTP)患者血管内皮损伤程度,以及不同类型TTP之间血管内皮损伤差异性。方法纳入2005年4月2010年12月特发性TTP患者17例(A组),继发性TTP患者15例(B组),骨髓移植相关TTP患者2例(C组),疑似TTP患者11例(D组),共45例;另选取健康体检志愿者为对照组10例(E组)。采用双夹心酶联免疫吸附试验测定血管性血友病因子前肽(vonWillebrand factor propeptide,vWFpp)水平。结果 vWFpp水平为其与正常混合血浆的比值,A组为2.2,B组为2.34,C组为2.795,D组为1.72,E组为1.08。A、B、C、D组患者vWFpp水平与E组比较,差异有统计学意义(P<0.05),A、B、C、D组间比较,差异无统计学意义(P>0.05)。结论 TTP患者vWFpp水平明显增高,提示血管内皮损伤明显,但vWFpp水平不能用于鉴别TTP类型。
Objective To investigate the degree of vascular endothelial injury in patients with thrombotic thrombocytopenic purpura (TTP) and the difference of vascular endothelial injury between different types of TTP. Methods 17 patients with idiopathic TTP (group A), 15 patients with secondary TTP (group B), 2 patients with TTP associated with bone marrow transplantation (group C), 11 patients with suspected TTP (D group), a total of 45 cases; the other health volunteers for the control group of 10 patients (E group). Double-sandwich enzyme-linked immunosorbent assay was used to determine von Willebrand factor propeptide (vWFpp) levels. Results The ratio of vWFpp to normal mixed plasma was 2.2 in group A, 2.34 in group B, 2.795 in group C, and 1.72 in group D and 1.08 in group E, respectively. The level of vWFpp in group A, B, C and D was significantly different from that in group E (P <0.05). There was no significant difference between group A, B, C and D (P> 0.05). Conclusion The level of vWFpp in patients with TTP was significantly higher than that in patients with TTP, suggesting that vascular endothelial injury was obvious. However, the level of vWFpp could not be used to identify the type of TTP.