B淋巴细胞特异单克隆鼠白血病病毒整合位点基因-1及辅助性T淋巴细胞相关细胞因子在儿童免疫性血小板减少症中的变化

Changes and significance of B cell specific monoclonal murine leukemia virus integration site - 1 and helper Tcell- related cytokine in children with immune thrombocytopenia

目的通过检测新诊断免疫性血小板减少症（ITP）患儿B淋巴细胞特异单克隆鼠白血病病毒整合位点基因-1（Bmi-1）及辅助性T淋巴细胞相关因子1干扰素（IFN-γ）、白细胞介素4（IL-4）mRNA的表达变化，分析探讨Bmi-1及Th1／Th2细胞比例在新诊断ITP患儿中的变化及意义。方法试验组36例ITP患儿均来源于新乡医学院第一附属医院儿科2013年4至12月住院和门诊患儿，同期小儿外科择期手术患儿26例作为对照组，采用反转录-聚合酶链反应（RT-PCR）方法检测外周血淋巴细胞中Bmi-1、TFN-γ、IL-4mRNA的表达；并采用t检验和直线相关分析进行分析比较。结果1．试验组外周血淋巴细胞中Bmi-1 mRNA为2．63±0．54，对照组Bmi-1 mRNA为3．91±0．92，试验组明显低于对照组（P〈0．001）；试验组IFN-γmRNA为3．84±0．43，对照组IFN-γmRNA为2．88±0．57，试验组明显高于对照组（P〈0．001）；试验组IL-4mRNA为1．444-0．39，对照组IL4mRNA为1．874-0．34，试验组明显低于对照组（P〈0．001）。2．试验组外周血淋巴细胞中IFN-γmRNA表达与IL-4mRNA表达呈负相关（r=一0．667，P〈0．001），IL-4mRNA表达与Bmi-1mRNA表达呈正相关（r=0．776，P〈0．001），IFN-γmRNA表达与Bmi-1mRNA表达无相关性（r=一0．206，P〉0．05）。结论Bmi-1可能通过调节Th细胞参与ITP发病；ITP患儿存在Th细胞功能紊乱、Th1／Th2比例失调，可能是Th1优势。

Objective To analyze the functional changes and the clinical significance of B cell specific mono- clonal murine leukemia virus integration site - 1 （ Bmi - 1 ） and Th1/Th2 cells in children with newly diagnosed im- mune thrombocytopenia（ITP） by testing the mRNA expressions of Bmi- 1 ,helper T cell- related eytokine interferon （IFN） - γ and interleukin （IL） - 4 in children with newly diagnosed ITP. Methods Thirty - six cases of patients with newly diagnosed ITP in the experimental group came from the inpatient and outpatient children admitted to the Depart- ment of Pediatrics of the First Affiliated Hospital of Xinxiang Medical University from April to December 2013. In the control group,26 cases of children requiring selective operation were admitted to the Department of Pediatric Surgery during the same period. The mRNA expressions of Bmi - 1, IFN - γ and IL - 4 in the peripheral blood lymphocytes were detected by means of the reverse transcription- polymerase chain reaction（ RT- PCR） method,and were analyzed and compared by t test and linear correlation analysis. Results （ 1 ） The mRNA expressions of Bmi - 1, IFN - γ and IL - 4 in peripheral blood lymphocytes in the experimental group were 2.63 ± 0.54,3.84 ± 0.43 and 1.44 ± 0.39, respec- tively ; while the mRNA expressions of Bmi - 1, IFN - γ and IL - 4 in the peripheral blood lymphoeytes in the control group were 3.91 ± 0.92,2.88 ± 0.57 and 1.87 ± 0.34, respectively. The levels of IFN - γ of the experimental group were significantly higher than those of the control group （ P 〈 0. 001 ） and the levels of Bmi - 1 and IL - 4 in the experi- mental group were significantly lower than those in the control group （all P 〈 0. 001 ）. （2） The mRNA expressions be- tween IFN -γ and IL -4 in the pe,ipheral blood lymphoeytes in the experimental group were in negative correlation （r = -0. 667 ,P 〈0. 001 ）. The mRNA expressions between IL -4 and Bmi -1 in the same group were in a positive correlation （r = 0. 776 ,P 〈 0. 001 ）. There were no correlation in the mRNA expressions between IFN- γ and Bmi- 1 （ r = - 0. 206, P 〉 0.05 ）. Conclusions Bmi - 1 may be involved in the pathogenesis of ITP by regulating Th cell, and Th cell dysfunction may occur in the children with ITP, and the disproportion between Thl and Th2 may be due to the advantages of Th1.