免疫性血小板减少症患儿免疫功能的研究及意义

The anayisis of immune functionin in children with immune thrombocytopenia

目的检测初治免疫性血小板减少症(immune thrombocytopenia,ITP)患儿外周血淋巴细胞亚群、免疫球蛋白、补体水平,探讨免疫性血小板减少症的发病机制及意义。方法选取2016年3月至2017年6月郑州大学第一附属医院儿科病房收治的97例初治ITP患儿为ITP组,选取同期40例健康体检儿童为对照组。观察两组淋巴细胞亚群及免疫球蛋白补体水平,利用免疫荧光法流式细胞分析技术(FCM)分别检测ITP患儿和对照组儿童外周血T淋巴细胞亚群、B淋巴细胞、自然杀伤细胞(natural killer cells,NK cells)表达水平,利用免疫散射比浊法检测血清中IgG、IgM、IgA、C3、C4的水平。结果 ITP组CD_3^+T淋巴细胞百分比、CD_4^+T淋巴细胞百分比及CD_4^+/CD_8^+均低于对照组,CD_8^+百分比高于对照组,差异有统计学意义(P<0.05);两组NK细胞百分比及B淋巴细胞百分比差异无统计学意义(P>0.05)。ITP组IgG、IgA水平高于对照组,IgM、C3、C4水平低于对照组,差异有统计学意义(P<0.05)。结论初治ITP患儿CD_3^+T淋巴细胞百分比、CD_4^+T淋巴细胞百分比、CD_4^+/CD_8^+T、IgM、C3、C4水平降低,IgG、IgA水平升高。

Objective To investigate the thrombocytopeniathe pathogenesis of immune thrombocytopenia（ ITP） by detecting lymphocyte subsets,immunoglobulin,complement in peripheral blood of children with initial treatment of immune thrombocytopenia. Methods Ninety children with ITP in the First Affiliated Hospital of Zhengzhou University from March of 2016 to June of2017 were selected as the ITP group,and 40 healthy children were selected during the same period as the control group. The levels of lymphocyte subsets and immunoglobulin complement in two groups were observed,the percentage of T lymphocyte subgroup,B lymphocyte,NK cell in peripheral blood of children with immune thrombocytopenia were detected by flow eytometric analysis technology（ FCM）. The serum levels of immunoglobulin IgG,IgM,IgA and C3,C4 were tested by immune scatter turbidity assay. Results The percentage of CD3＋T lymphocytes,CD4＋T lymphocytes and CD4＋/CD8＋,the levels of IgG,IgM,IgA and C3,C4 in ITP group were significantly lower than those in control group（ P〈0. 05）. The percentage of CD8＋,the levels of IgG and IgA in ITP group was higher than that in control group,the difference was statistically significant（ P〈0. 05）.There was no significant difference in the percentages of NK cells and B lymphocytes between the two groups（ P〈0. 05）.Conclusion The percentage of CD3＋T cell and CD4＋T cell,the levels of CD4＋/CD8＋and IgM,C3,C4 in children with ITP decrease,and the levels of IgG and IgA are decrease.