Comparison Of Platelet Membrane Glycoprotein Specific Antibodies And Bleeding Scores In Primary And Secondary Immune Thrombocytopenia Patients

Objective:Primary Immune Thrombocytopenia ITP is an autoimmune disease characterized by increased platelet clearance,which results in bleeding in patients.The clearance of platelets is mainly caused by the autoantibody Ig G of platelet membrane glycoprotein(GP).Relevant studies have suggested that the production of platelet antibodies can also be detected in patients with secondary immune platelets.This study aimed to investigate the expression of anti-platelet GP IIb/IIIa and GP Ib/IX antibodies in plasma of patients with primary and secondary immune thrombocytopenia,as well as the relationship between the expression of antibodies and the bleeding score.Methods: 42 patients with ITP and 42 patients with secondary immune thrombocytopenia were enrolled.All patients were scored with the ITP Bleeding Scale at admission.The anti-GPIIb/IIIa and anti-GPIb /IX antibodies in vivo were detected by modified MAIPA method.Results:(1)There was no significant difference in the overall expression rates of anti-GPIIb/IIIa antibodies and anti-GPIb/IX antibodies between primary and secondary groups(Z=0.499,P=0.503).Anti-GPIIb/IIIa antibodies were mainly expressed in primary group,while anti-GPIb/IX antibodies were mainly expressed in secondary group.There was statistically significant difference in the composition ratio between the two(Z=8.539,P=0.036).(2)Compared with the primary group,the overall bleeding degree in the secondary group was more severe(Z=-2.878,P=0.04).(3)Relationship between antibody and bleeding degree:(1)Immune thrombocytopenia patients with positive antibodies were more severe than those with negative antibodies(Z=-4.043,P < 0.001)(2)anti-GPIb/IX patients with positive antibodies were more severe than those with negative antibodies(Z=-3.664,P < 0.001).,the bleeding degree of patients with positive double antibodies was worse than that of patients with negative antibodies(Z=-3.479,P=0.01)Conclusions: 1.The positive expression of anti-GPIIb /IIIa antibody and anti-GPIb/IX antibody had no differentiation significance between primary and secondary immune thrombocytopenia,but the antibody expression of primary ITP patients was mainly anti-GPIIb /IIIa antibody,while that of secondary ITP patients was mainly anti-GPIb /IX antibody.2.The clinical bleeding degree of patients with secondary immune thrombocytopenia was more severe than that of patients with primary immune thrombocytopenia.3.Anti-GPIIb/IIIa antibody and anti-GPIb /IX antibody were both positive,and the degree of bleeding in patients with positive anti-GPIb /IX antibody was more serious than those with negative antibody.