儿童慢性特发性血小板减少性紫癜CD40及CD40L的表达和意义

Expression and significance of CD40 and CD40L in children with chronic idiopathic thrombocytopenic purpura

目的研究CD40、CIMOL在儿童慢性特发性血小板减少性紫癜（cITP）中的表达及其临床意义。方法应用流式细胞术检测30例cITP患儿治疗前后及30例对照组儿童外周血单个核细胞中CIM0及CD40L的表达情况，用ELISA法检测血小板抗体（PAIgG）。结果与对照组比较，cITP患儿CD40和CIMOL治疗前后的表达均增高（P〈0．05），CD40治疗前高于治疗后（P〈0．05），CD40L在两组的表达差异无统计学意义（P〉0．05）；CD40、CD40L的表达与PAIgG均呈正相关（r分别为0．708、0．772，P〈0。01）。结论cITP患儿外周血单个核细胞CD40及CD40L表达增高，常规治疗后CD40较治疗前降低，CD40L在两组的表达差异无统计学意义，表明CD40、CD40L在儿童cITP发病机制中可能起着重要作用，阻断此共刺激途径可能会取得更好的治疗效果。

Objective To investigate the expression of CO - stimulatory molecules CD40 and CD40L on peripheral blood mononuclear cells of patients with childhood chronic idiopathic thrombocytopenic purpura（ cITP）, and to investigate their possible roles in the disease. Methods Flow cytometry was used to semiquantitatively analyze CD40 and CD40L expression in peripheral blood mononuclear cells from 30 cITP patients and 30 normal controls. Platelet - associated antibody were detected by enzyme linked immunosorbent assay （ELISA） technique. Results Compared with controls, the expression of CD40 and CD40L were higher in prior treatment group and post - treatment group （P 〈 0. 05 ）. Compared with post - treatment group, the expression of CD40 in prior treatment group were higher （P 〈 0. 05） , but the expression of CD40L were not different （P 〉 0. 05 ）. The expression of CD40 and CD40L had positive correlation with PAIgG （ r = 0. 708, 0. 772 ;P 〈 0.01 ）. Conclusions The expression of CD40 and CD40L in cITP group were higher. Compared with post - treatment group, the expression of CD40 in prior treatment group were higher after conventional therapy, but CD40L is no obviously decrease. The abnormal expression of CD40 and CD40L may play an important role in the development of childhood cITP. It may get better effective treatment if we can obstruct this costimulate way.