急性特发性血小板减少性紫癜患儿T细胞亚群、NK细胞及IFN-γ、IL-4变化的探讨

Study on the changes of T-cell subsets,NK cells,IFN-γ and IL-4 in children with aITP

目的通过检测急性特发性血小板减少性紫癜(ITP)患儿T细胞亚群、NK细胞、IFN-γ、IL-4,探讨急性ITP患儿的发病机制。方法采用流式细胞仪检测32例急性ITP患儿及20例对照儿童外周血T细胞亚群、NK细胞比例,采用双抗体夹心酶联免疫吸附试验定量方法检测两组儿童外周血IFN-γ、IL-4水平,并采用t检验和直线相关分析进行比较分析。结果急性ITP患儿CD3+、CD4+、CD4+/CD8+细胞水平均明显低于对照组(P值均<0.001),CD8+细胞水平明显高于对照组(P<0.001);NK细胞水平与对照组比较差异无显著性(P>0.05);血清IFN-γ水平明显高于对照组(P<0.01),IL-4水平明显低于对照组(P<0.01);CD4+、CD8+细胞百分比的改变与血小板计数无明显相关性(P>0.05),IFN-γ与IL-4水平呈明显负相关(P<0.001)。结论急性ITP患儿存在T淋巴细胞亚群失衡,同时存在细胞因子紊乱,可能是Th1优势疾病,NK细胞与儿童急性ITP发病机制的关系尚不明确。

Objective To discuss the pathogenesis in children with acute immune thrombocytopenic purpura （aITP） through the detection of T-cell subsets,NK cells,IFN-γ and IL-4.Methods T-cell subsets and NK cells were detected by flow cytometry in 32 patients with aITP （aITP group） and 20 healthy children （control group）.The concentrations of IFN-γ and IL-4 were detected by ELISA as well.The data were analyzed by T-test and linear correlation.Results The CD3＋,CD4＋ and CD4＋/CD8＋ levels in aITP group were lower than those in control group （P ＜ 0.001）,while the CD8 ＋ level was higher in aITP group （P ＜0.001）.There was no difference of NK-cell levels between aITP and control groups （P ＞0.05）.The IFN-γ level in aITP group was higher than that in control group （P ＜0.01）,while the IL-4 level was lower in aITP group （P ＜ 0.01）.The proportions of CD4 ＋ and CD8 ＋ in aITP group had no correlation with platelet counts （P ＞ 0.05） ; IFN-γ had a negative correlation with IL-4 （P ＜ 0.001）.Conclusions T-cell subsets and cytokines expression were abnormal in the children with aITP,which might present as a Thl-dominant disease.It is still unclear about the relationship between NK cells and aITP.