特发性血小板减少性紫癜患儿红细胞CR_1基因型、红细胞免疫功能及其调节功能的探讨

RBCCR1 genotype polymorphism and RBC immune function in childhood ITP

目的：探讨儿童特发性血小板减少性紫癜（ＩＴＰ）与红细胞免疫的关系。方法：采用聚合酶链反应（ＰＣＲ）技术与郭峰方法，对２２例ＩＴＰ、３０例过敏性紫癜（ＡＰ）患儿与５０名正常儿童进行了红细胞ＣＲ１数量多态性基因型（基因型）、红细胞免疫功能及其调节功能的检验。结果：①ＩＴＰ患儿红细胞ＣＲ１基因高表达型１８例（８２％）、中表达型４例（１８％）、低表达型为０，中表达型显著高于ＡＰ及正常儿童（Ｐ＜０．０１）。②ＩＴＰ患儿红细胞Ｃ３ｂ受体花环率（ＲＢＣ－Ｃ３ｂＲＲ）及红细胞Ｃ３ｂ受体花环促进率（ＲＢＣ－Ｃ３ｂＲＦＥＲ）均显著低于正常儿童（ｔ值分别＝１５．３７，８．９１，Ｐ均＜０．０１），红细胞免疫复合物花环率（ＲＢＣ－ＩＣＲ）及红细胞Ｃ３ｂ受体花环抑制率（ＲＢＣ－Ｃ３ｂＲＦＩＲ）均显著高于正常儿童（Ｐ均＜０．０１）。③ＩＴＰ红细胞ＣＲ１基因型与其ＲＢＣ－Ｃ３ｂＲＲ及ＲＢＣ－Ｃ３ｂＲＦＥＲ均呈负相关（Ｐ均＜０．０５），与ＲＢＣ－ＩＣＲ及ＲＢＣ－Ｃ３ｂＲＦＩＲ均呈正相关（Ｐ均＜０．０５）。结论：红细胞免疫参与ＩＴＰ的发病，ＩＴＰ患者红细胞ＣＲ１基因型异常，红细胞免疫功能降低，免疫调节功能失衡，为临床采用基因及免疫调节剂治疗Ｉ?

Objective:To investigate the RBC immune functions in childhood idiopathic thrombocytopenic purpura (ITP).Methods:RBCCR1 polymorphism genotype,RBC immune function and its regulator function were detected in 22 ITP,30 allergic purpura (AP) and 50 normal children by PCR and Guo Feng,s method. Results:①There were 18 cases of high expression(82%) and 4 of medium expression(18%) of RBCCR1 genotypes in the ITP cases. The rate of the medium expression genotype was significantly higher in ITP than that in AP and normal children (P<0.01).②The rates of RBCC3bRR and RBCC3bRFER were much lower(P<0.01),and the rates of RBCICR and RBCC3bRFIR were significantly higher in ITP than those in normal children (P<0.01).③RBCCR1 genotypes in ITP were correlated negatively with RBCC3bRR and RBCC3bRFER (P<0.05),but positively with RBCICR and RBCC3bRFIR(P<0.05).Conclusion:RBC immune participated in the pathogenesis of ITP.