Relative Efficacy Of Steroid Therapy On The Expression Of Different Platelet-speciifc Autoantibodies (GPIIbIIIa/GPIbα) With ITP Patients

Background Immune thrombocytopenic purpura (ITP) is an immune-mediatedthrombocytopenia syndrome, because of their own antibody-sensitized platelets wasclicked-macrophage system transition thrombocytopenia caused by damage, causingclinical bleeding. GPIIb/IIIa, GPIbIα is two major resistance in patients with ITP plateletmembrane glycoprotein-specific autoantibody. Foreign experts found anti-GPIbaantibody-mediated ITP for treatment less effective. Combined with the use ofglucocorticoid in the treatment of patients with ITP choice, we detect ITP glucocorticoidtreatment-specific autoantibodies and clinical variability.Methods Speific antibodies were measured with MAIPA in261ITP patients.Clinicalretrospective on steroid in treating patients with reactions，comparison of differentautoantibodies against platelet and its clinical therapeutic effects of steroid differences.Further IgG, IgM antibody detection in patients, comparing different type-specificautoantibodies (IgG and IgM) and steroid therapy. Separately for162patientsaccompanied by two different anticoagulants EDTA and heparin testing, comparingdifferent anticoagulant effect on antibody detection rate, so as to enhance understandingof the spatial configurations of Antigen.Results A majority of patients with antibodies against GPIIb/IIIa （45/59=76.3%）weresensitive to the treatment. Their response rate was2.1times higher than theresponse rate from patients with antibodies against GPIbα (X~2=25.379，P<0.01)or those patients double positive for both GPIIb/IIIa and GPIbα (X~2=13.062， P<0.01).Furthermore, no significant was observed between patients with anti-GPIIb/IIIaantibodies and those with no detectibel antibody (χ~2=1.323，P>0.05)，althoughpatients double negative for antibodies had a weak trend towards being more sensitive toseroid therapy. For136patients, where further IgG, IgM testing. In the IgG group, a singleanti-GPIIbIIIa-positive scaling19.8%(27/136), a single anti-GPIbα antibody8.1%(11/136), double-antibody-positive ratio is20.6%(28/136), the proportion of IGMantibody-negative51.5%(70/136). Comparison between the various groups, nosignificant differences (P>0.05). In the IgM group, a single anti-GPIIbIIIa-positivescaling17%(23/136), a single anti-GPIbα antibody7.4%(10/136), double-antibody-positive ratio is8.8%(12/136), the proportion of IGM antibody-negative66.8%(91/136).Comparison between the various groups, no significant differences (P>0.05).Group of162patients were detected．Single anticoagulants group and dual anticoagulants groupcomparison differences are statistically significant in detection of GP IIb／IIIa(χ~2=8.56,P<0.05； χ~2=7.78,P<0.05). In detection of GPIbα, Single anticoagulants groupand dual anticoagulants group comparison differences are also statisticallysignificant(χ~2=5.92,P<0.05； χ~2=7.47,P<0.05).Conclusions Anti-GPIbα antibodies exist，regardless of the presence or absence ofanti-GPIIb/IIIa antibodies, steroid therapy in patients with reduced. IgG, IgMantibodies and steroid effect no significant difference, need to further expand the sampleto clear.There is significant effect in detection of different anticoagulant detected ITPplatelet specific antibodies on modified MAIPA．Both EDTA and heparin anticoagulantscombined detection rate can improve ITP platelet specific antibodies(GP IIb／Ⅲa andGPIbα).