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血小板数量减少与自身免疫性疾病和病毒有关

2014-12-10 Mădălina Mocanu等 科研出版社

慢性免疫性血小板减少性紫癜(ITP)的特征,是血液中血小板数量少。血小板减少发生在血小板早期被严重破坏的情况下。原因有两种,要么是一些抗血小板的自身抗体引起的,要么是一些免疫性复合血小板膜导致血小板被巨噬细胞吸收。血小板短暂的生命是一种自身免疫机制的结果。在ITP患者的血液循环中,血小板的寿命会大大缩短,平均存活时间从2~3天减少到几分钟。产生了抗体的血小板常常会孤立,然后在脾脏中被毁掉,而肝脏和

慢性免疫性血小板减少性紫癜(ITP)的特征,是血液中血小板数量少。血小板减少发生在血小板早期被严重破坏的情况下。原因有两种,要么是一些抗血小板的自身抗体引起的,要么是一些免疫性复合血小板膜导致血小板被巨噬细胞吸收。血小板短暂的生命是一种自身免疫机制的结果。在ITP患者的血液循环中,血小板的寿命会大大缩短,平均存活时间从2~3天减少到几分钟。产生了抗体的血小板常常会孤立,然后在脾脏中被毁掉,而肝脏和网状内皮髓质系统在血小板的隔离中发挥了重要作用。

罗马尼亚医药大学Magda B descu学者指出,在患有自身免疫性疾病(系统性红斑狼疮、抗磷脂综合征、自身免疫性甲状腺炎、伊文思综合征)、骨髓增生性综合征、淋巴细胞性白血病,感染乙型、丙型肝炎病毒、巨细胞病毒, 或是感染艾滋病毒的情况下,常常发生二次ITP,妊娠或药物可以诱导二次ITP。科研出版社英文期刊 Journal of Biomedical Science and Engineering (生物医学工程)上发表了学者的这篇文章。

血小板计数

这项研究显示了二次ITP中的病毒性病原体和细菌,还分析了这些“触发器”之间的关联,通过外周血涂片评估血小板数量。首先,得出血小板数量(PC)的差异率为32.8%,范围在33 - 87 × 103/μL以内,平均值为60.20 ± 19.75 × 103/μL。接下来调查了过去认证的血小板减少症的病因,进行了免疫学和病毒学的分析。

抗血小板抗体量

研究发现,80%的患者抗血小板抗体检测为阳性,PC范围略少于检测检测结果为阴性的患者。抗血小板抗体被认为是与ITP诊断相关性最大的要素,体液免疫反应紊乱,源于抗原细胞和淋巴细胞T和B之间复杂的相互作用,而血小板就是呈递抗原细胞。

确定乙肝病毒表面抗原(AgHBs)

乙肝病毒抗原的测定强调了乙肝病毒表面抗原,人的血浆/血清中存在AgHBs表明感染过乙肝病毒(有多达40%的感染患者不会显示出临床症状)。在研究组中,只有20%的患者AgHBs检测呈阳性,这些患者的PC平均值略高,但与呈阴性的患者比较差异不明显。

丙肝病毒(HCV)抗体测试

这项测试证明了与丙肝病毒不同的免疫球蛋白G(IgG)抗体产生的证据。HCV有六个主要基因型和50种血清类型。测试表明,对这六个基因型的高灵敏度来自不同地理区域的人。了解基因型和血清类型非常有用。

艾滋病毒抗体量

研究人员发现,艾滋病毒抗体检测为阳性的患者,PC平均值较低,在这种情况下,血小板减少症源于ITP。巨细胞感染和艾滋病也可能造成血小板减少症。艾滋病患者患上ITP还有可能是机会性感染、恶性疾病或某些药物(化疗、干扰素和抗病毒药物)引起的。

免疫球蛋白M(IgM)抗体抗巨细胞病毒抗体量

在研究中,30%的患者的IgM巨细胞病毒抗体检查为阳性,他们的PC平均值与阴性结果的患者没什么差异。12位患者无一人乙肝抗体检查呈阳性结果,仅有四位抗丙肝抗体呈阴性。

学者通过研究发现,慢性ITP有两种形式:初次(原发性)和二次。二次发作与其他相关病症有关,因此,准确诊断ITP建立在那些疾病病因的诊断上。原发性血小板减少症则涉及到相关病症产生了抗血小板抗体。

这项研究强调病毒剂在在慢性ITP发病机制中发挥了作用。案例研究表明乙型、丙型肝炎病毒、艾滋病毒或巨细胞病毒及导致血小板减少症的抗血小板抗体之间的关系。


原始出处:

Mădălina Mocanu, Magda Bădescu, Manuela Ciocoiu, Oana Bădulescu.Aspects of Viral Involvement in Chronic Immune Thrombocytopenic Purpura.Journal of Biomedical Science and Engineering.DOI: 10.4236/jbise.2014.714104

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    2016-03-14 忠诚向上

    好好学习,继续研究

    0

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    2016-03-14 忠诚向上

    好好学习,继续研究

    0

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    2016-03-14 忠诚向上

    好好学习,继续研究

    0

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    2016-03-14 忠诚向上

    好好学习,继续研究

    0

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    2016-03-14 忠诚向上

    好好学习,继续研究

    0

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    2014-12-19 rosa00tong

    自身免疫性疾病与病毒感染密不可分

    0

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