Determination And Clinical Significance Of GPⅡb/Ⅲa,P-Selectin And VWF In Children With Henoch-Schonlein Purpura

ObjectiveHenoch-Schonlein purpura(HSP) is one of the most common vasculitiic diseases in childhood,and the incidence of renal injury in children with HSP ranges from 20-100%.The prognosis of HSP is mainly determined by the involvement of the kidney,called Henoch-Schonlein purpura nephritis(HSPN),and HSPN probably as a result of immune-mediated endothelial cell damage.It has been reported that high coagulation state play an important role in the development of HSPN.To study the relationship of coagulation state and renal involvement in patients with HSP,we measured platelet membrane glycoproteinⅡb/Ⅲa,P-selectin and von Willebrane Factor in 44 patients with HSP and 18 healthy children in the control group.MethodsAll of the 44 patients had purpurs in acute phase,in the catbasis,clinical symptom of the 40 patients,including purpurs,stomachache and joint pain,disappeared in 2 weeks.All of patients had no history of taking some drugs,such as hormone, decoagulant and haemostatic,which may affect coagulate state,and they have no illness,such as the hematologic diseases,the liver diseases and heart diseases before and during the study.The concenraions of CD41a/CD61,CD-62P were measured by flow cytometry,vWF and D-D were measured by enzyme-linked immunosorbent assay(ELISA) method. Results:1.The plasma levels of CD41a/CD61,CD-62P,vWF in acute phase were significantly higher than those in recovery period,and higher than those in healthy controls (P＜0.01).2.The plasma levels of CD41a/CD61,CD-62P,vWF were higher in renal damage group than that in non-renal damage group(P＜0.01).3.There is no difference of the plateles levels between the pateins of HSP in acute phase and in recovery phase and those in healthy controls(P＞0.05),There is no difference of the plateles levels between the patients of HSPN and those of non-renal damage.4.The plasma levels of D-D in acute phase were sigificantly higher than those in recovery period of HSP,and higher than those in healthy controls(P＜0.01).There is no difference beween the group of HSP in recovery period and that in the healthy controls.5.In acute phase of HSP,the high plasma levels of CD41a/CD61,CD62P,vWF were related with the high levels of D-D(P＜0.01).Conclusion1.The study provides evidence that the activation of platelet and the damage of vascular endothelium play an important role in the pathgenesis for HSP.2.The damage of vascular endothelium and the activation of platelet are associated with the HSPN.