慢性特发性血小板减少性紫癜B淋巴细胞数量及凋亡蛋白表达的研究

Quantity and apoptosis-related protein level of B lymphocytein patients with Chronic Idiopathic Thrombocytopenic Purpura(CITP)

目的探讨B淋巴细胞数量在慢性特发性血小板减少性紫癜(CITP)发病中的作用。方法用流式细胞仪对30例CITP患者及20位健康对照者外周血总B淋巴细胞、CD5+B淋巴细胞的数量及B淋巴细胞膜表面凋亡相关蛋白Fas抗原(CD95),胞浆内凋亡蛋白Bcl-2表达水平进行测定。结果CITP初诊患者外周血总B淋巴细胞数及CD5+B淋巴细胞数均明显高于治疗后和对照组,差异有显著性(P均<0.01),后两组相比,差异无显著性(P均>0.05);三组间B淋巴细胞Fas蛋白的表达率无显著性差异(P均>0.05);初诊患者B淋巴细胞胞浆内Bcl-2的表达率显著高于其他两组(P均<0.01),治疗后血小板恢复正常组也显著高于对照组(P<0.01);各组间B淋巴细胞凋亡相关指数(CD19+CD95+/CD19+Bcl-2+)比较,初诊组显著低于治疗后血小板恢复正常组和对照组(P<0.05或<0.01),治疗后血小板升至恢复正常组也显著低于对照组(P<0.01)。结论CITP患者自身抗体的产生可能与B淋巴细胞及其亚群数量异常、凋亡受抑有关。

Objective Detecting the quantity and apoptosis-related protein level of B lymphocyte in the patients with Chronic Idiopathic Thrombocytopenic Purpura(CITP) and explore the role of B lymphocyte in the pathogenetic mechanism of CITP.Methods Uantities of all B lymphocytes and CD_5^+B lymphocytes and the expressions of Fas and Bcl-2 on B lymphocytes in 30 patients with CITP,23 patients with CITP in complete remisson(CR) and 20 normal controls were assayed by FACS.Results The percentages of B lymphocyte and CD_5^+B lymphocytes were significantly higher in untreated ITP patients than in CR ITP patients and normal controls.(P<0.05);there were no significant deference in the latter two groups(P>0.05).There were no significant deference of Fas expression in B lymphocytes among the three groups.(P>0.05).The expression of Bcl-2 on B lymphocytes was significantly higher in untreated patients than that in CR patients or normal controls(P<0.05), and so did in CR patients than in normal controls(P<0.05).The apoptosis-related index was significantly lower in untreated patients than in CR patients or normal controls(P<0.05)and it was lower in CR patients than that in normal controls(P<0.05).Conclusion The increasing of auto-antibodies in CITP patients probably has some relationships with the abnormal quantities of B lymphocyte and its subsets, or with the inhibition of B lymphocyte apoptosis. 【