过敏性紫癜病儿急性期免疫细胞功能变化

FUNCTIONAL CHANGES OF IMMUNE CELLS IN CHILDREN WITH HENOCH-SCHONLEIN PURPURA IN ACUTE STAGE

目的探讨过敏性紫癜（HSP）病儿急性期免疫细胞功能变化及其意义。方法以53例HSP急性期病儿为研究对象，并根据有无尿检异常分为。肾炎（HSPN）组和非肾炎（NHSPN）组，以30例正常儿童作为对照组。采用流式细胞术检测3组外周血CD3^＋细胞、CD4^＋细胞、CD8^＋细胞、CD4^＋／CD8^＋比值、CD4^＋CD25^＋细胞、NK细胞（CD16^＋CD56^＋）和B淋巴细胞（CD19^＋）水平。结果HSPN组和NHSPN组外周血CD3^＋细胞、CD4^＋细胞、CD4^＋／CD8’比值、CD4^＋CD25^＋细胞和NK细胞水平较对照组显著降低，CD8^＋细胞和B淋巴细胞水平较对照组显著增高（F=6．80～46．40，q=2．81～4．25，P〈0．01、0．05），而HSPN组和NHSPN组间比较差异无统计学意义（P〉0．05）。HSP病儿CD4^＋CD25^＋细胞水平与CD4^＋细胞、CD4^＋／CD8^＋比值呈正相关（r=0．369、0．285，P〈0．01、0．05），与CD19^＋细胞呈负相关（r=-0．279，P〈0．05），而与CD8^＋细胞和CD16^＋CD56^＋细胞无相关性（r=0．009、-0．104，P〉0．05）。结论HSP病儿急性期存在免疫细胞功能异常，T细胞亚群紊乱，CD4^＋CD25^＋T细胞和NK细胞数量降低，导致B细胞呈多克隆活化，在HSP发病机制中具有重要作用。

Objective To investigate the functional changes of immune cells in children with Henoch-Schonlein Purpura （HSP） in acute stage and their significance. Methods Fifty-three children with HSP were involved in this study, who were divided into Henoch-Schonlein Purpura-nephritis （HSPN） group and non-HSPN （NHSPN） based on whether the urine analysis was normal or not. Thirty healthy children were served as control. Flow cytometry was applied to detect the amounts of CD3^＋ cells, CD4^＋ cells and CD8^＋ cells, CD4^＋/CD8^＋ ratio, and the levels of CD4^＋ CD25^＋ cells, NK cells （CD16^＋ CD56^＋） and B cells （CD19^＋ ） in peripheral blood. Results The amounts of CD3^＋ cells, CD4^＋ cells, CD4^＋ CD25^＋ cells, NK ceils and the ratio of CD4^＋/CD8^＋ in the HSP and NHSPN children were significantly lower than those in the control children, while CD8^＋ cells and B cells were significantly higher （F=6. 80-46. 40 ;q=2.81-4.25 ;P〈0. 01,0. 05）. The differences between those in HSP and the NHSPN children were not significant （P〉0.05）. The amount of CD4^＋ CD25^＋ cells of the HSP was positively correlated with that of CD4^＋ cells and CD4^＋/CD8^＋ ratio （r= 0. 369, P〈0.01 ; r= 0. 285, P〈0.05）, and negatively correlated with tthat of CD19^＋ cells （r= -0. 279 ,P〈O. 05）, but not correlated with those of CD8^＋ cells and CD16^＋ CD56^＋ cells （r=0. 009,-0. 104;P〉0.05）. Conclusion Children with HSP in acute stage have a disordered cell-mediated immunity, which mainly manifests as derangement of T-cell subsets, decrease of CD4^＋CD25^＋ T cells and NK cells, resulting in polyclonal B-cell activities, which plays an important role in the pathogenesis of this condition.