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    张丹, 吴冬会, 傅磊, 陆尧, 王科, 李玉云. Cbl-b基因和血小板参数在免疫性血小板减少症病人中的表达及临床意义[J]. 蚌埠医科大学学报, 2023, 48(10): 1412-1416. DOI: 10.13898/j.cnki.issn.1000-2200.2023.10.019
    引用本文: 张丹, 吴冬会, 傅磊, 陆尧, 王科, 李玉云. Cbl-b基因和血小板参数在免疫性血小板减少症病人中的表达及临床意义[J]. 蚌埠医科大学学报, 2023, 48(10): 1412-1416. DOI: 10.13898/j.cnki.issn.1000-2200.2023.10.019
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    ZHANG Dan, WU Dong-hui, FU Lei, LU Yao, WANG Ke, LI Yu-yun. Expression and clinical significance of Cbl-b gene and platelet parameters in patients with immune thrombocytopenia[J]. Journal of Bengbu Medical University, 2023, 48(10): 1412-1416. DOI: 10.13898/j.cnki.issn.1000-2200.2023.10.019
    Citation: ZHANG Dan, WU Dong-hui, FU Lei, LU Yao, WANG Ke, LI Yu-yun. Expression and clinical significance of Cbl-b gene and platelet parameters in patients with immune thrombocytopenia[J]. Journal of Bengbu Medical University, 2023, 48(10): 1412-1416. DOI: 10.13898/j.cnki.issn.1000-2200.2023.10.019
    shu

    Cbl-b基因和血小板参数在免疫性血小板减少症病人中的表达及临床意义

    Expression and clinical significance of Cbl-b gene and platelet parameters in patients with immune thrombocytopenia

      摘要
    • 摘要:
      目的检测Cbl-b基因和血小板参数在原发免疫性血小板减少症(ITP)病人外周血单个核细胞(PBMCs)中的表达情况，并研究其临床意义。
      方法选取68例初诊的ITP病人(ITP组)和同期40名健康的体检者(对照组)为研究对象，检测并比较2组间Cbl-b mRNA的相对表达量和血小板参数血小板计数(PLT)、平均血小板体积(MPV)、血小板体积分布宽度(PDW)和大血小板比率(P-LCR)的差异，分析ITP组病人不同亚组分组间Cbl-b mRNA表达的差异以及其与部分临床指标的相关性，分别采用logistic回归和ROC曲线分析发生ITP的影响因素以及其对ITP的诊断价值。
      结果ITP组Cbl-b mRNA的表达和PLT低于对照组，MPV、PDW和P-LCR高于对照组(P < 0.01)。Cbl-b mRNA的表达随着血小板分级增高而增高，出血评分 < 2分组的Cbl-b mRNA的表达量高于出血评分≥2分组(P < 0.05~P < 0.01)。Cbl-b mRNA的表达与PLT呈正相关关系(P < 0.01)，与出血评分、MPV和P-LCR均呈负相关关系(P < 0.05~P < 0.01)。logistic回归分析表明Cbl-b mRNA低表达(OR=17.525，95%CI：2.589~118.637)、MPV升高(OR=2.515，95%CI：1.506~4.200)和P-LCR升高(OR=1.211，95%CI：1.067~1.376)可能是ITP发生的独立危险因素(P < 0.01)。ROC曲线分析显示Cbl-b mRNA、MPV、P-LCR及三者联合预测发生ITP的AUC分别是0.920、0.899、0.883和0.972，联合检测的预测AUC均高于单项检测。
      结论ITP病人PBMCs中Cbl-b基因表达降低，MPV和P-LCR升高，Cbl-b与出血评分、PLT、MPV和P-LCR有一定的相关性，三者的异常表达是发生ITP的危险因素，联合检测三者对于是否发生ITP具有较高预测价值。

       

      Abstract:
      ObjectiveTo detect the expression of Cbl-b gene and platelet parameters in peripheral blood mononuclear cells (PBMCs) of patients with primary immune thrombocytopenia (ITP) and investigate their clinical significance.
      MethodsA total of 68 patients initially diagnosed with ITP (ITP group) and 40 healthy subjects (control group) were selected for the study.The relative expression of Cbl-b mRNA and platelet parameters platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW) and platelet larger cell ratio (P-LCR) were detected and compared between the two groups.The difference in Cbl-b mRNA expression between other subgroups of patients in the ITP group was detected and its correlation with some clinical indicators was analyzed.Logistic regression and ROC curves were used to analyze the risk factors for the development of ITP as well as its diagnostic value for ITP.
      ResultsThe expression of Cbl-b mRNA and PLT in the ITP group were lower than those in the control group (P < 0.01).MPV, PDW and P-LCR were higher than those in the control group (P < 0.01).The expression of Cbl-b mRNA increased with higher platelet grading, and it was higher in the bleeding score < 2 points subgroup than it in the bleeding score ≥2 points subgroup (P < 0.05 to P < 0.01).The expression of Cbl-b mRNA was positively correlated with PLT (P < 0.01) and negatively correlated with bleeding score, MPV and P-LCR (P < 0.05 to P < 0.01).The logistic regression analysis showed that the decreased expression of Cbl-b mRNA (OR=17.525, 95%CI: 2.589-118.637), elevated MPV (OR=2.515, 95%CI: 1.506-4.200) and elevated P-LCR (OR=1.211, 95%CI: 1.067-1.376) may be the independent risk factors for ITP (P < 0.01).The ROC curve analysis showed that the area under curve for Cbl-b mRNA, MPV, P-LCR and the combination of the three indicators to predict the occurrance of ITP were 0.920, 0.899, 0.883 and 0.972, and the predicted area under curve of the combined tests was higher than that of the single test.
      ConclusionsCbl-b gene expression in PBMCs is decreased, MPV and P-LCR are increased in ITP patients.Cbl-b gene correlates with bleeding score, PLT, MPV and P-LCR, and the abnormal expression of them may be a risk factor for ITP.Combined detection of the three indicators has a high predictive value for ITP.

       

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