Level Of Plasma Coagulation Factor ⅩⅢ In Primary Immune Thrombocytopenia And Correlation With Bleeding Symptom

Background and Objective:ITP is a hemorrhagic disease characterized by thrombocytopenia caused by dysfunction of immune cells.Although there are many clinically proven therapeutic methods,it still cannot be cured.Different degrees of bleeding symptoms are still the main reason affecting the quality of life of patients.However,platelet count alone cannot accurately predict the bleeding risk of ITP patients.Therefore,in this paper,by measuring the plasma coagulation factor XIII concentration in untreated primary immune thrombocytopenia patients,the differences in plasma coagulation factor XIII levels between ITP patients and healthy people were analyzed,and then the effect of plasma coagulation factor XIII levels on the bleeding degree of ITP patients was investigated,and the related factors between them.Methods:A total of 50 patients with definite diagnosis of ITP who were hospitalized in the First Hospital of Lanzhou University from September 2019 to December 2021 were selected,and the remaining plasma of these patients after routine coagulation index examination was collected.Another 34 healthy people without coagulation function were randomly selected as the control group 1.In addition,32patients with non-APL acute leukemia during chemotherapy-induced severe myelosuppression（≥grade III）were selected as the control group 2.After routine coagulation index examinations,the remaining plasma samples of these people were collected to detect the plasma FXIII-A₂B₂ tetramer concentration level by the enzyme-linked immunosorbent assay（ELISA）method.SPSS 26.0 was used for statistical analysis of these data.Results:（1）The plasma coagulation factor XIII level of untreated patients with primary immune thrombocytopenia was lower than that of healthy people,with a statistically significant difference（P<0.01）.（2）In terms of bleeding severity,according to the Chinese Guidelines for the Diagnosis and Treatment of Primary Immune Thrombocytopenia in Adults（2020 Edition）,the bleeding score of ITP patients was negatively correlated with the plasma XIII concentration.When the cut-off value of plasma coagulation factor XIII level was 503.8778ng/ml,the sensitivity and specificity of diagnosing bleeding in untreated ITP patients were 0.938 and 0.735 separately.（3）.Compared with leukemia patients in the severe myelosuppression stage,the plasma FXIII in ITP patients was significantly higher（P<0.01）.Conclusion:The level of plasma FXIII in untreated ITP patients was decreased,and was negatively correlated with the severity of bleeding,which was one of the independent factors for the occurrence of bleeding symptoms in patients with ITP.Plasma FXIII levels were higher in ITP patients compared with leukemia patients in the myelosuppression stage,indicating that unclarified compensatory mechanisms may be related to the source of coagulation factor XIII in ITP.