The Correlative Relationship Between Human Parvovirus B19(hpv-b19) Infection And Idiopathic Thrombocytopenic Purpura(itp)

ObjectiveChildren with idiopathic thrombocytopenic purpura(ITP) is an autoimmune syndrome,which belong to a common pediatric hemorrhagic disease.Tt is blood circulation in the anti-platelet antibody to excessive platelet destruction caused Purpura,and megakaryocyte cells in the bone marrow of normal or increased,the naive.Acute type disease mostly attended by the virus infection,such as upper respiratory tract infections,rubella,measles,chickenpox,or after vaccination.The incubation period is 1-3 weeks between ITP an infection Mainly for skin and mucous membrane bleeding,often more serious,skin ranging from the size of the hemorrhage was Stasis,uneven distribution to more limbs,bleeding,bleeding under the eye membrane with a small number of retinal hemorrhage.Common intracranial hemorrhage or spinal cord,can cause lower limb paralysis or intracranial hypertension performance can be life-threatening.B19 virus is a single-stranded DNA virus,belong to a tiny Branch,B19 infection will produce specific antibody,is the rash of common pediatric diseases-infectious disease(also known as fifth disease,Erythema infection,EI) etiology.In immunodeficiency patients can cause persistent infection.If the B19 infection during pregnancy,can cause miscarriages,stillbirths and the incidence of fetal edema.It also hematopoietic system with a variety of abnormalities such as reduction of neutrophil and platelet reduction of the.Related reports indicated that a typical ITP patients in the peripheral blood or bone marrow B19 DNA-positive rate,and anti-B19 IgM and IgG positive rate was significantly higher,suggesting that children with idiopathic thrombocytopenic purpura and B19 may be related to an infection.Based on this study of 50 cases of idiopathic thrombocytopenic purpura(ITP) patients(study group) and 48 healthy infants(control group) by PCR to human parvovirus B19(B19-HPV) DNA testing and related clinical indicators Detection study HPV-B19 infection and the incidence of ITP,with a view to the diagnosis and treatment of ITP to provide new evidence.Material and Methods1.Select Case50 ITP patients in our hospital were Choiced form June 2002 to December 2005, of which 29 male and female 21 patients,aged 2.4 years of age to12.5 years,31 cases of acute and chronic type 19 cases.All children are 0 moment of the Chinese Medicine Council of Scientific Hematology Group to develop the diagnostic criteria for ITP.The control group was 48 cases in the pediatric outpatient physical health of children,including 28 cases of male,20 female,age 2.5 years old to 13 years old.Two groups of age and gender has comparability.2.Methods1).HPV-B19 IgM,IgG detection:serum by ELISA detection of HPV-B19 IgM and IgG.2).HPV-B19 DNA tests:children with the early morning fasting blood collected in 5 ml of anticoagulant,leukocyte PCR detection of HPV-B19 DNA3).T cell subsets detection:the use of direct immunofluorescence staining method,the patients were analyzed by flow cytometry detection of peripheral blood T cell subsets.4).Blood tests:blood after mining by automatic blood cell analyzer to measure the blood cell count,platelet count,platelet pressure plot,mean platelet volume,and mean platelet distribution width. 5).Megakaryocyte cell count and differential count:bone marrow puncture smear, Wright stained counting,classificationResult①HPV-B19-DNA and HPV-B19-Ab in ITP group were significantly increased compared with the control group(p＜0.01 or 0.05),the position rate of HPV-B19-DNA in AITP was higher than that of CITP(p＜0.01).②In the ITP group,there were significant differece of T cell subsets(CD4~+,CD8~+ and CD4~+/CD8~+) between the HPV-B19-IgM position cases and the HPV-B19-IgM negative cases(p＜0.01 or 0.05).③.T cell subsets Detection:healthy control group,acute and chronic ITP group ITP Group blood T-cell subsets showed that the group of acute and chronic ITP ITP group and acute ITP group,acute ITP group reduced CD4~+ cells,CD4~+/CD8~+ ratio decreased(P＜0.01).④.Perpheral blood tests:Automatic Determination of blood cells showed that acute ITP Group B19 DNA in the HPV-positive acute ITP group and HPV-negative comparison B19 DNA in peripheral blood platelet count decreased significantly(P＜0.05),and mean platelet volume Acute ITP Group B19 DNA in the HPV-positive acute ITP group with HPV-negative comparison B19 DNA significantly increased(P＜0.01).⑤.Megakaryocyte cell count and differential count:bone marrow punctured befire smeared,Wright stained before counted,classification showed that acute ITP Group B19 DNA in the HPV-positive acute ITP group with HPV-negative B19 DNA comparison of the total number of megakaryocyte has no significant differences(P＞0.05),but the middle plate megakaryocyte cells was significantly decreased(P＜0.05).Conclusion①The infection and disorders of immunoreaction induceded by HPV-B19 are bound up with ITP,the HPV-B19 infection may play an important role in the pathologic process of ITP.②The low expression of Notchl protein may contribute to invasion and transference of esophageal squamous cell carcinoma.