ITP患者淋巴细胞亚群及调节性T细胞水平表达特征观察

Characterization of lymphocyte subsets and regulatory T cells in patients with ITP

目的研究自身免疫性血小板减少性紫癜患者外周血中调节性T细胞及T淋巴细胞亚群的表达特征。方法以本院2015年2月至2017年1月收治的70例自身免疫性血小板减少性紫癜患者作为观察组,以同期在本院接受健康体检的70例志愿者作为对照组,对比两组患者调节性T细胞:CD4^+、Treg、CD4^+CD25^-及Treg/CD4^+表达率,对比两组患者T淋巴细胞亚群:CD3^+、CD4^+/CD8^+、CD16^+56^+NK以及CD19^+B细胞表达率;分析上述指标检测结果与免疫性血小板减少性紫癜诊断的相关性,以ROC分析各项指标对于本病的最佳诊断值(尤登指数)以及诊断价值(AUC)。结果两组调节性T细胞:CD4^+、Treg、Treg/CD4^+表达率具有统计学差异,P<0.05;两组CD4^+CD25^-无统计学差异,P>0.05;两组患者淋巴细胞亚群:CD3^+、CD4^+/CD8^+、CD16^+56^+NK以及CD19^+B细胞表达率均具有统计学差异,P<0.05;Treg、Treg/CD4^+、CD3^+、CD16^+56^+NK、CD19^+B对于ITP的诊断具有较高诊断价值,曲线下面积(AUC)>0.9;CD4^+、CD4^+/CD8^+对于ITP的诊断具有中等诊断价值,AUC=0.7~0.9;CD4^+CD25^-对于ITP的诊断具有较低诊断价值,AUC=0.5~0.7;最佳诊断值:Treg为2.35%,Treg/CD4^+为6.15%,CD3^+为66.45%,CD16^+56^+NK为15.515%,CD19^+B为19.685%。结论ITP患者淋巴细胞亚群及调节性T细胞计数与正常人具有统计学差异,因此检测淋巴细胞亚群及调节性T细胞计数对于ITP的诊断具有较高的指导意义。

Objective To investigate the regulatory characteristics of regulatory T lymphocyte and T lymphocyte subsets in peripheral blood of patients with autoimmune thrombocytopenic purpura.Methods 70 cases in our hospital from February 2015 to January 2017 were autoimmune thrombocytopenic purpura patients as the observation group,in the same period in our hospital 70 cases of healthy volunteers as control group,compared two groups of patients with regulatory T cells：CD4^＋,Treg,CD4^＋CD25^-and Treg/CD4^＋expression rates were compared between the two groups T lymphocyte subsets：CD3^＋,CD4^＋/CD8^＋,CD16^＋56^＋NK and CD19^＋B expression rate;analysis of test results and the index of immune thrombocytopenic purpura associated with ROC diagnosis,analysis of the indicators for diagnosis of the disease the best off value（Uden index）and diagnostic value（AUC）.ResultsThe two groups of regulatory T cells：CD4^＋、Treg、Treg/CD4^＋expression rate was statistically significant,P〈0.05;no significant difference between the two groups of CD4^＋CD25^-P〈0.05;two groups of subsets of lymphocytes in patients with CD3^＋、CD4^＋/CD8^＋、CD16^＋56^＋NK and CD19^＋B expression rate were statistically difference,Treg,Treg/CD4^＋,P〈0.05;CD3^＋、CD16^＋56^＋NK、CD19^＋B has a high diagnostic value for the diagnosis of ITP,the area under the curve（AUC）0.9;CD4^＋、CD4^＋/CD8^＋has a moderate diagnostic value for the diagnosis of ITP,AUC=0.7～0.9;CD4^＋CD25^-has a low diagnostic value for the diagnosis of ITP,AUC=0.5～0.7;the best diagnostic value：Treg 2.350%,Treg/CD4＋6.150%,CD3^＋66.450%,CD16^＋56^＋NK is 15.515%,CD19^＋B is19.685%.Conclusion Lymphocyte subsets and regulatory T cell counts in ITP patients are significantly different from those in normal subjects,so detection of lymphocyte subsets and regulatory T cell counts is of high guiding significance for the diagnosis of ITP.