NK细胞在儿童免疫性血小板减少症发病和治疗中的意义

Significance of NK cell in the pathogenesis and treatment of childhood idiopathic thrombocytopenia

目的探讨自然杀伤细胞(NK细胞)在儿童免疫性血小板减少症(ITP)的发病和治疗中的意义。方法采用流式细胞仪分别检测62例新诊断ITP患儿、43例持续性ITP患儿、21例慢性ITP患儿和51例对照组儿童外周血NK细胞百分比;并观察单独使用标准剂量静脉注射用人免疫球蛋白(IVIG)对NK细胞百分比正常及减少的新诊断的ITP患儿的疗效。结果新诊断ITP患儿、持续性ITP、慢性ITP患儿NK细胞百分比均较正常对照组儿童显著降低(P<0.05),但三组ITP患儿NK细胞百分比差异无显著性(P﹥0.05);NK细胞百分比正常的新诊断ITP患儿单独使用IVIG有效率为92.86%(26/28),NK细胞百分比降低的新诊断ITP患儿单独使用IVIG有效率仅为14.70%(5/34)。结论 NK细胞表达变化与ITP发病存在一定关系,同时NK细胞百分比正常的新诊断ITP患儿可首选IVIG治疗。

Objective To explore the significance of natural killer cell（NK）in the pathogenesis and treatment of childhood idiopathic thrombocytopenia（ITP）.Methods Peripheral NK cell percentage was teseted by flow cytometry in 62 children with newly diagnosed ITP,43 children with persistent ITP,2 1 children with chronic ITP and 5 1 controls.All the newly diagnosed ITP children were treated with standard dose of intravenous immunoglobulin （IVIG ）. Then whether IVIG has a proven impact on the newly diagnosed ITP patients with normal or lower NK cells was observe.Results The percentage of NK cells in children with newly diagnosed ITP,persistent ITP and chronic ITP was all significantly decreased compared with the control group（P〈0.05 ）.But there was no significant difference among the three groups（P〉0.05 ）.The efficiency of standard dose of IVIG in newly diagnosed ITP children with normal NK cells and abnormal NK cells was 92.86%（26/28）and 14.70%（5/34）separately.Conclusions NK cell may play role in the pathogenesis of childhood ITP,and standard dose of IVIG is the first choice to treat newly diagnosed ITP children with normal NK cell.