Clinical Significance Of ANA In Patients With Primary Immune Thrombocytopenia

Objective: The aim of this study is to investigate the correlation between serum antinuclear antibody(ANA)and clinical features and disease development in patients with Primary Immune Thrombocytopeia(ITP).In order to provide reference for clinical judgment and prediction of disease development.Methods: A total of 160 patients with ITP who were first diagnosed and treated in the Affiliated Hospital of Youjiang Medical College for Nationalities from January 1,2019 to December 31,2021 and with complete case data were collected as the study group.And 50 healthy people were enrolled as the control group.The gender,age,Platelet(PLT)count,Hemoglobin(HB),White blood cell(WBC)count,and Immunoglobulin(Ig)of the two groups were recorded and analyzed.Ig)Ig G,Ig A,Ig M,Ig E,Complement(C)C3,C4,ANA,ANAs and other clinical data;According to the ANA expression,144 ITP patients were divided into ANA positive group(53 cases)and ANA negative group(91 cases).The correlation between the two groups in gender,age,PLT,HB,WBC,Ig G,Ig A,Ig M,Ig E,C3,C4,bleeding score,clinical classification and stage were analyzed.ITP patients with positive ANA were grouped according to ANA titer,and the correlation between ANA titer and thrombocytopenia grade was analyzed.SPSS 22.0 statistical software was used to analyze and process the data.Results:(1)The positive rate of ANA,Ig G and Ig E levels in the study group were significantly higher than those in the control group,while the levels of Ig A,Ig M,complement C3 and C4 were lower than those in the control group,and the differences were statistically significant(P<0.05).(2)There was no significant difference in HB,WBC,Ig A,Ig M,C3,C4,Ig E levels between ANA positive group and ANA negative group.(3)The initial platelet count of the ANA positive group was significantly lower than that of the negative group,while the bleeding score and Ig G level were significantly higher than those of the negative group(P<0.05).The ANA titer was positively correlated with the degree of thrombocytopenia(rs=0.275,P=0.047).(4)In the clinical classification and stage,the incidence of persistent ITP,chronic ITP and severe ITP in ANA positive group was significantly higher than that in ANA negative group,while the incidence of newly diagnosed ITP was lower than that in ANA negative group(P<0.001).Conclusion:(1)TThe positive rate of ANA in ITP patients was higher than that in healthy people.(2)ITP patients with positive ANA had a significantly lower initial platelet count and a significantly higher bleeding score,and were often accompanied by abnormal immune function,especially Ig G.Therefore,ANA test may provide a reference index for identifying the severity of ITP patients.(3)ITP patients with positive ANA were more likely to develop into chronic ITP and severe ITP,and ANA could be used as a predictive factor for disease classification and staging.