Th1/Th2细胞平衡偏移在原发性免疫性血小板减少性紫癜发病机制中的作用

Value of Th1/Th2 cell balance deviation in the occurance machanism of primary thrombocytopenic purpura

目的探讨原发性免疫性血小板减少性紫癜患者治疗前后外周血Th1/Th2细胞因子变化水平及其临床意义。方法 96例ITP患者分为激素治疗有效组和无效组;选择健康体检正常者40例为对照组,分别检测各组治疗前、治疗后4周、3个月、6个月外周血Th1细胞因子和Th2细胞因子变化,并分析指标间的相关性。结果治疗前,初治ITP组外周血Th1细胞因子明显高于对照组,Th2细胞因子明显低于对照组,差异均有统计学意义(P<0.05);治疗后,激素治疗有效组Th1细胞水平均较治疗前明显下降,差异均有统计学意义(P<0.05);而激素治疗无效组则差异均无统计学意义(P>0.05)。结论初治ITP患者外周血Th1/Th2细胞存在平衡偏移现象,ITP是一种Th1优势疾病,治疗前后Th1/Th2细胞因子变化对指导ITP个体化治疗有一定的临床意义。

Objective To explore the clinical significance of the levels change of Th1 and Th2 type cytokines in patients with primary idiopathic thrombocytopenic purpura. Methods 96 patients with ITP were divided into hormone therapy effective group and ineffective group compared with those 40 persons for heath examination as the control group. The levels of Th1 and Th2 type cytokines were measured after 4 weeks,3 month,6 month of treatment,and analyze the relationship between the indicators.Results Before treatment,the levels of Th1 type cytokineswere in 96 patients with ITP were higher and the levels of Th2 type cytokines were lower compared with the healthy controls,and the difference was statistically significant（ P 〈0. 05）. After treatment,in the effective group,the levels of Th1 type cytokineswere significantly decreased compared with before treatment,with the difference statistically significant（ P 〈0. 05）,but in ineffective group,the difference on the Th1 / Th2 type cytokines levels were not statistically significant（ P 〈0. 05）. Conclusion The patients with primary ITP have the balance deviation of peripheral blood Th1 / Th2 cells,ITP is a Th1 dominated disease,before and after treatment,the changes of Th1 / Th2 cytokines have a certain clinical significance in ITP individualized treatment.