摘要
目的探讨树突状细胞(DC)在慢性特发性血小板减少性紫癜(ITP)发病中的作用及糖皮质激素治疗对外周血DC亚群的影响。方法四色荧光流式细胞术分析35例ITP患者糖皮质激素治疗前、治疗后及20名健康人(对照组)外周血DC前体细胞亚群pDC1/pDC2(CD11c+CD123-/CD11c-CD123+)比值。结果35例ITP患者中,6例外周血pDC缺乏,其余29例患者外周血pDC1/pDC2比值为0.77±0.16,低于对照组(1.94±0.44)(P<0.05);治疗后无外周血pDC缺乏患者,血小板计数>100×109/L者27例,pDC1/pDC2比值为1.83±0.43,较治疗前显著升高(P<0.05),与对照组比较差异无统计学意义(P>0.05);血小板计数<100×109/L者8例,pDC1/pDC2比值为1.17±0.24,较治疗前显著升高(P<0.05),但与对照组比较,仍显著降低(P<0.05)。结论慢性ITP患者外周血pDC数量缺乏或pDC1相对减少;糖皮质激素治疗可提升患者外周血pDC数量,完全或部分纠正DC亚群失衡。
Objective To explore the changes of the dendritic cells subsets in peripheral blood in patients with chronic ITP and the effect of corticosteroid on it. Methods The peripheral blood was collected for assay from 35 cases of patients with chronic ITP and 20 cases of healthy controls. The subsets of the precursors of dendritic cell （pDC） were analyzed by four-color FCM. Results The ratio of pDC1/pDC2 in peripheral blood from 29 cases of patients was 0.77 ± 0.16 except for 6 cases deficient of pDC before corticosteroid therapy, which was lower than that in healthy controls （ 1.94 ±0.44） （P 〈 0.05） ; no patient was deficient of pDC after corticosteroid therapy, the ratio of pDC1/pDC2 in 27 cases with the counts of platelets〉 100 × 10^9/L was 1.83 ± 0.43, which increased markedly than that before therapy （P〈0.05） and there was no significant difference compared with that in controls （P 〉0.05）. The ratio of pDC1/ pDC2 in 8 cases with the counts of platelets〈 100 × 10^9/L was 1.17 ± 0.24, which increased significantly than that before therapy （P 〈 0.05 ）, but decreased significantly than that in controls （ P 〈 0.05 ）. Conclusion The peripheral blood are deficient of pDC or pDC1 is decreased compared to pDC2 in patients with chronic ITP, corticosteroid therapy can enhance the number of pDC and improve the imbalance of pDC subsets.
基金
深圳市卫生科技计划基金资助项目(200204052)
