CD4^+CD25^+调节性T细胞及转化生长因子-1在血小板输注无效患者中的表达和意义

Expression and significance of CD4^+CD25^+ regulatory T cells and transforming growth factor-β1 in patients with platelet transfusion refractoriness

目的研究CD4^+CD25^+调节性T细胞及转化生长因子-β1(TGF-β1)在血小板输注无效症(PTR)患者中的表达和意义。方法选取2017年4月~2018年4月广州市第一人民医院(以下简称“我院”)收治的重症再生障碍性贫血(SAA)发生PTR患者34例作为为研究组。另取选取同期我院收治的SAA未发生PTR患者44例作为对照组。分别检测并比较两组患者CD4^+CD25^+调节性T细胞及血浆TGF-β1表达水平,并采用受试者工作特征曲线(ROC)分析上述两项指标在PTR中的诊断效能。结果输注前后研究组CD4^+CD25^+调节性T细胞表达水平低于对照组(P <0.05),且研究组血浆TGF-β1水平低于对照组(P <0.05)。经ROC曲线分析发现,CD4^+CD25^+调节性T细胞、TGF-β1联合检测诊断PTR的曲线下面积、敏感性、特异性高于上述两项指标单独检测(P <0.05)。结论 PTR患者CD4^+CD25^+调节性T细胞及TGF-β1水平均存在明显低表达,临床工作中可通过联合检测上述两项指标的表达情况,为临床PTR的防治提供参考依据。

Objective To investigate the expression and significance of CD4^+CD25^+ regulatory T cells and transforming growth factor-β1 (TGF-β1) in patients with platelet transfusion refractoriness (PTR). Methods Thirty-four patients with severe aplastic anemia (SAA) who had PTR from April 2017 to April 2018 in Guangzhou First People′s Hospital ("our hospital" for short) were selected as the study group. Another 44 SAA patients without PTR were selected as the control group. The expression levels of CD4+CD25+ regulatory T cells and plasma TGF-β1 were detected and compared in the two groups, and the diagnostic performance of the two indicators in PTR was analyzed by receiver operating curve (ROC). Results The expression levels of CD4^+CD25^+ regulatory T cells in the study group before and after infusion were lower than those in the control group (P < 0.05), and the plasma TGF-β1 level in the study group was lower than that in the control group (P < 0.05). According to ROC curve analysis, the area, sensitivity and specificity of CDT^+CD25^+ regulatory T cells and TGF-β1 combined detection and diagnosis of PTR were higher than those of the above two indicators (P < 0.05). Conclusion CD4+CD25^+ regulatory T cells and TGF-β1 levels in PTR patients are significantly lower than those in control group. The expression of these two indicators can be detected in clinical work, which can provide reference for the prevention and treatment of PTR.