CD80、CD86表达与ITP患者免疫紊乱的相关性研究

The Study of the Relationship between CD80/CD86 Expression in B Cells and Immune Disorders in Patients with Immune Thrombocytopenia

目的研究CD80、CD86表达与免疫性血小板减少症(ITP)患者免疫紊乱的相关性。方法纳入90例ITP患者作为研究对象,采用流式细胞术检测所有患者外周血中CD19^+CD 80^+、CD19^+C D 86^+及CD19^+B细胞内抗体I g G、 I g M的表达水平。所有患者均接受重组人血小板生成素(rh TPO)^+泼尼松治疗,随访记录完全缓解率,采用Logistic多因素分析探讨I T P预后高危因素,采用偏相关分析C D 19^+C D 80^+、CD19^+C D 86^+与Ig G、Ig M表达水平的相关性。结果随访3～11个月,平均随访时间(7.95±2.74)月,ITP完全缓解率为46.67%,多因素分析结果显示CD19^+CD80^+、CD19^+CD86^+、IgG及IgM是影响预后的高危因素(P <0.05)。CD19^+C D 80^+与Ig G、Ig M呈线性分布,经偏相关分析发现均具有正相关性(r=0.229,0.592;P=0.031,P <0.001)。CD19^+86^+与IgG、IgM呈线性分布,经偏相关分析发现均具有正相关性(r=0.415,0.292,P <0.001,0.005)。结论 CD80和CD86与免疫紊乱密切相关,是影响ITP患者预后的高危因素,CD80和CD86的过度表达可能是CD19^+B细胞过度活化,并介导免疫功能紊乱的重要机制。

Objective To study the relationship between CD80/CD86 expression in B cells and immune disorders in patients with immune thrombocytopenia(ITP).Methods 90 patients with ITP were enrolled in the study,the flow cytometry was used to detect the expression CD80^+/CD86^+in CD19^+B cells,the IgG/IgM level in peripheral blood.All patients were treated with recombinant human thrombopoietin(rhTPO)and prednisone,the complete remission rate was recorded by followed up,Logistic analysis was used to test the risk factors of the prognosis of ITP the partial correlation analysis was used to test relationship between CD19^+CD80^+,CD19^+CD86^+and IgG,IgM expression.Results The patients were followed up for 3-11 months with an average follow-up time of(7.95±2.74)months,the complete remission rate of ITP was 46.67%.The multivariate analysis showed that CD19^+CD80^+,CD19^+CD86^+,IgG and IgM level were the high risk factors of prognosis(P<0.05).The CD19^+CD80^+and IgG,IgM had linear distribution,the partial correlation analysis showed significant positive correlation(r=0.229,0.592;P=0.031,P<0.001).The CD19^+CD86^+and IgG,IgM had linear distribution,the partial correlation analysis showed significant positive correlation(r=0.415,0.292,P<0.001,0.005).Conclusion The CD80 and CD86 are closely related to immune disturbances,and they are the high risk factors for the prognosis of patients with ITP,the over expression of CD80 and CD86 in B cells may be the important mechanism for over activation of CD19^+B cells and mediated immune dysfunction.