过敏性紫癜患儿血小板α颗粒膜蛋白及血栓调节蛋白水平变化的研究

Changes of Plasma Levels of Platelet Alph Granule Membrane Protein and Thrombomodulin in Children with Henoch Sch enlein Purpura

摘要:

目的：探讨血小板α颗粒膜蛋白(GMP-140)及血栓调节蛋白(TM)在过敏性紫癜(HSP)患儿中的变化及其作用。方法：采用ELISA法测定30例过敏性紫癜患儿(12例合并肾脏损害)急性期和恢复期血浆GMP-140及TM浓度，并对二者之间的相关性进行分析。结果：急性期过敏性紫癜患儿血浆GMP-140及血浆TM浓度明显高于正常对照组［(87.35±21.74) μg/L vs (38.43±19.16) μg/L；(4.53±1.33) μg/L vs (2.90±0.19) μg/L］，两组比较差异有显著性意义(P<0.01)；血浆GMP-140浓度恢复期较急性期明显下降［(41.06±12.38) μg/L vs (87.35±21.74) μg/L］(P<0.05)。血浆TM浓度恢复期较急性期变化不明显［(3.77±0.68) μg/L vs (4.53±1.33) μg/L］，二者比较差异无显著性意义(P>0.05)，但仍高于正常对照组［(3.77±0.68) μg/L vs (2.90±0.19) μg/L］(P<0.05)。紫癜性肾炎患儿血浆GMP-140及TM浓度较未合并肾脏损害的过敏性紫癜患儿明显升高［(90.21±22.03) μg/L vs (63.70±17.44) μg/L; (4.69±0.22) μg/L vs (4.01±0.37) μg/L］，二者比较差异有显著意义（P<0.01 或 0.05）。血浆GMP-140与TM浓度二者呈正相关(r=0.713，P<0.01)。结论：血管内皮细胞受损和血小板活化是HSP发病机制的二个重要环节。测定血浆GMP-140及TM浓度有助于了解病情轻重及是否合并肾脏损害。动态测定有助于观察病情演变、判断预后及指导治疗。

Abstract:

OBJECTIVE: To study the changes and the role of platelet alpha granule membrane protein (GMP 140) and thrombomodulin (TM) in children with Henoch Schenlein purpura (HSP). METHODS: Plasma concentrations of GMP 140 and TM were assayed using ELISA in 30 children with HSP. The correlation between GMP 140 and TM was studied. Sixteen healthy children served as the controls. RESULTS: The plasma concentrations of GMP-140 and TM increased in the acute phase compared with those in the controls [( 87.35 ± 21.74 ) μg/L vs ( 38.43 ± 19.16 ) μg/L;( 4.53 ± 1.33 ) μg/L vs ( 2.90 ± 0.19 ) μg/L] (both P< 0.01 ); and the plasma GMP 140 concentration returned to the normal level during in the remission phase. The plasma concentrations of GMP 140 and TM in children with HSP complicated by renal lesions were apparently higher than those without renal lesions [( 90.21 ± 22.03 ) μg/L vs ( 63.70 ± 17.44 ) μg/L, P< 0.01 ; ( 4.69 ± 0.22 ) μg/L vs ( 4.01 ± 0.37 ) μg/L, P< 0.05 ]. There was a positive correlation between GMP 140 and TM (r= 0.713 ,P< 0.01 ). CONCLUSIONS: Vascular endothelial damages and platelet activation may be the two important factors in the pathogenesis of HSP. Dynamic measurement of plasma concentrations of GMP 140 and TM is of great value in assessing progress and prognosis and determining proper treatment for HSP.