外周血Th17细胞对大剂量地塞米松治疗免疫性血小板减少症长期疗效的预测价值

Predictive value of Th17 cells on the long-term efficacy of high-dose dexamethasone in the treatment of patients with immune thrombocytopenia

目的评价免疫性血小板减少症(ITP)病人外周血Th17细胞比例对大剂量地塞米松(DXM)长期疗效的预测价值。方法采用流式细胞术检测42例初诊ITP病人外周血Th17细胞比例,分析Th17细胞比例在持续反应组病人(15例)及复发组(18例)病人之间的差异,应用受试者工作曲线法(ROC)分析Th17细胞比例对大剂量DXM长期疗效的预测价值。结果复发组病人治疗前外周血Th17细胞比例显著高于持续反应组病人(P<0.01)。应用治疗前外周血Th17细胞比例预测大剂量DXM的长期疗效,其曲线下面积为0.857(95%CI:0.717～0.998,P<0.01),cut-off值为1.235%。结论初诊外周血Th17细胞比例有助于预测大剂量DXM在ITP的长期疗效。

Objective To assess the value of Th17 cells on predicting long-term efficacy of high-dose dexamethasone(DXM)in the treatment of patients with immune thrombocytopenia(ITP).Methods Flow cytometry was used to detect Th17 cells in 42 newly-diagnosed ITP patients,and the difference of Th17 ratios was compared between sustained responders and relapsed patients.The predictive efficiency of Th17 cells on long-term efficacy of high-dose DXM was evaluated by receiver operating characteristics(ROC)curve analysis.Results The ratio of Th17 cells at diagnosis in relapsed ITP patients was significantly higher than that in sustained responders(P<0.01).When long-term efficacy of high-dose DXM was evaluated by ROC curve analysis,the area under curve was 0.857(95%CI:0.717-0.998,P<0.01),cut-off value of Th17 cells ratio was 1.235%.Conclusion Ratios of Th17 cells in peripheral blood at diagnosis were useful for predicting the long-term efficacy of high-dose DXM in ITP patients.