特发性血小板减少性紫瘢患者外周血淋巴细胞亚群和调节性T细胞的变化及临床意义

Changes in Peripheral Blood Lymphocyte Aubsets and Regulatory T Cells in Idiopathic Thrombocytopenic Purpura Patients and the Clinical Significance

目的研究特发性血小板减少性紫癜(ITP)患者外周血淋巴细胞亚群、调节性T细胞(Treg细胞)水平变化及临床意义。方法采用流式细胞仪对40例ITP患者及40例正常人外周血淋巴细胞亚群及调节性T细胞水平进行检测。结果初诊ITP组与正常对照组比较,CD3+T淋巴细胞百分比、CD4+T淋巴细胞百分比、CD4+/CD8+比值及CD16+/56+NK细胞百分比均显著降低(P<0.01),CD8+T淋巴细胞百分比略升高(P>0.05),CD19+B淋巴细胞百分比显著升高(P<0.01)。ITP患者外周血中CD4+CD25+T细胞占CD4+T细胞的百分比高于正常对照组(P<0.05),CD4+CD25highT细胞比例略高于对照组(P>0.05),CD4+CD25+Foxp3+T细胞占CD4+T细胞的百分比显著低于正常对照组(P<0.05)。结论 ITP患者细胞免疫功能明显异常,CD4+CD25+Foxp3+Treg细胞减少可能与ITP免疫发病机制有关。淋巴细胞亚群及调节性T细胞水平检测在评价ITP疗效及判断预后方面具有一定的临床价值。

Objective To study the changes and clinical significance of lymphocyte subsets and regulatory T cells in peripheral blood of patients with idiopathic thrombocytopenic purpura （ITP）. Methods Peripheral blood lymphocyte subsets and regulatory T cells of 40 ITP patients and 40 normal controls were measured with flow cytometry. Results Compared with the nomlal group, the percentage of CD3 ＋ T lymphocyte,CD4＋T lymphocyte and CD16＋/56＋NK cell and ratio of CD4＋/CD8＋ decreased markedly in ITP group （P 〈 0.01 ）,while the percentage of CD8＋T lymphocyte increased slightly （P 〉 0.05 ） and CD19＋B lymphocyte increased significantly （P 〈 0.01 ）. In ITP patients, the proportion of CD4＋ CD25＋ T cells in CD4＋ T cells was higher than that d the control group （P 〈 0.05 ） and the proportion （ff CD4＋ CD25lngh T cells was slightly higher （ P 〉 0.05 ）, while the proportion of CD4＋ CD25 ＋ Foxp3 ＋ regulatory T cells was lower （ P 〈 0.05 ）. Conclusion Cellular immune function in patients with 1TP is obviously abnormal and the decreased proportion of CD4＋CD25＋Foxp3＋ regulatory T cells may be related to the immune pathogenesis of ITP. Detection of lymphocyte subsets and regulatory T cells is of some clinical value in evaluation of therapeutic effect and prognosis of ITP.