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目的:探讨微小病毒B19(HPV B19)、血小板相关抗体(PA)和白细胞介素(IL)-2、IL-4在成人难治性血小板减少症(ITP)患者的改变和相关性及其在ITP发病机制中的作用。方法:应用ELISA检测血清中HPVB19-IgG、IgM、PA-IgG、IgM、IgA及IL-2、IL-4水平。结果:①ITP组HPV B19-IgG、IgM阳性数分别为15例、3例,正常对照组分别为3例、0例,2组比较,IgG阳性率差异有统计学意义(P<0.01);IgM型差异无统计学意义(P>0.05)。②对ITP患者根据HPV B19抗体结果分为2组,阳性组15例,PA阳性13例;阴性组7例,PA阳性4例。2组比较差异无统计学意义(P>0.05)。③ITP组IL-2和IL-4水平分别为(47.54±25.74)pg/ml、(34.20±16.79)pg/ml,对照组IL-2和IL-4水平分别为(6.15±1.25)pg/ml、(19.72±4.36)pg/ml,2组比较均差异有统计学意义(均P<0.01)。结论:成人难治性ITP的发病机制复杂,可能与体内细胞因子分泌亢进及HPVB19既往感染有关,这种感染与PA无关;这对于指导临床治疗针对不同的环节具有重要的意义。
OBJECTIVE: To investigate the changes and correlations of parvovirus B19 (HPV B19), platelet-associated antibodies (PA) and interleukin (IL) -2 and IL-4 in patients with adult refractory thrombocytopenia The role of ITP pathogenesis. Methods: Serum levels of HPVB19-IgG, IgM, PA-IgG, IgM, IgA, IL-2 and IL-4 were detected by ELISA. Results: (1) The positive numbers of HPV B19-IgG and IgM in ITP group were 15 cases, 3 cases, 3 cases in normal control group, 0 cases and 2 cases respectively. The positive rate of IgG was statistically significant (P <0.01) Type difference was not statistically significant (P> 0.05). ② According to the results of HPV B19 antibody, ITP patients were divided into two groups, 15 cases were positive, 13 cases were positive for PA, 7 cases were negative and 4 cases were positive for PA. There was no significant difference between the two groups (P> 0.05). ③ The levels of IL-2 and IL-4 in the experimental group were (47.54 ± 25.74) pg / ml and (34.20 ± 16.79) pg / ml respectively, while those in the control group were 6.15 ± 1.25 pg / ml , (19.72 ± 4.36) pg / ml respectively. There was significant difference between the two groups (all P <0.01). Conclusion: The pathogenesis of refractory ITP in adults is complex and may be related to the excretion of cytokines in vivo and the previous infection of HPVB19. This infection has nothing to do with PA, which is of great significance for guiding clinical treatment in different aspects.