过敏性紫癜患儿外周血T淋巴细胞亚群CD45RA^+、CD45RO^+表达的研究

Study of peripheral blood T lymphocyte subsets CD45RA+and CD45RO+in children withHenoch-Schonlein purpura

目的 探讨过敏性紫癜(HSP)患儿在不同临床分型下,外周血T淋巴细胞亚群CD45RA^+和CD45RO^+的变化及意义.方法 回顾性分析川北医学院附属医院儿科2015年10月至2017年7月住院治疗的HSP患儿80例的临床资料,根据临床分型分为单纯型组35例、腹型组36例、肾型组9例;另选择健康儿童80例为对照组.两两对照比较外周血T淋巴细胞亚群CD45RA^+、CD45RO^+的表达率,探讨T淋巴细胞亚群CD45RA^+、CD45RO^+、CD45RA^+与 CD45RO^+比值(RA/RO 比值)变化的意义.结果 80 例患儿中,男性40例,女性40例,年龄(7.2 ± 2.3)岁;CD4 CD45RA^+所占百分比(RA比率)、CD4CD45RO^+所占百分比(RO比率)分别为(13.19 ± 7.09)%、(12.07 ± 3.46)%,均明显低于对照组的(23.26 ± 6.01)%、(21.74 ± 3.46)%,差异均有统计学意义(t=9.69、16.42,均P<0.05).肾型组RA比率、RA计数、RA/RO比值分别为(8.02 ± 3.63)%、(2.19 ± 0.33)个/μL、(-0.28 ± 0.19),均明显低于单纯型的(15.74 ± 7.71)%、(2.55 ± 0.33)个/μL、(0.27 ± 0.12),差异均有统计学意义(t=3.085、2.709、4.013,均P<0.05);腹型组RA/RO比值为(-0.07 ± 0.27),明显低于单纯型组的(0.27 ± 0.12),差异有统计学意义(t=2.989,P<0.05).结论 外周血T 淋巴细胞亚群 CD45RA^+、CD45RO^+在 HSP 患儿免疫功能变化的发生、发展中起着一定作用,CD45RA^+T细胞的减少可能与紫癜型肾炎的发生有关.

Objective To observe the change and clinical significance of the peripheral blood T-lymphocytes CD45RA^+and CD45RO^+in children with Henoch-Schonlein purpura(HSP)under different clinical classification.Methods From October 2015 to July 2017,the clinical data of 80 children with HSP in the Affiliated Hospital of North Sichuan Medical College were retrospectively analyzed.According to the clinical classification,they were divided into three groups:skin involvement group(35 cases),abdominal type group(36 cases),and renal type group(9 cases).Another 80 healthy children were selected as the control group.The changes and clinical significance of peripheral blood T-lymphocytes CD45RA^+,CD45RO^+and CD45RA^+/CD45RO^+ratio were analyzed.Results Among the 80 children,40 cases were male and 40 cases were female,with age of(7.2 ± 2.3)years old.The CD45RA^+and CD45RO^+rates in the HSP group were(13.19 ± 7.09)%,(12.07 ± 3.46)%,respectively,which were significantly lower than those in the control group [(23.26 ± 6.01)%,(21.74 ± 3.46)%],the differences were statistically significant(t=9.69,16.42,all P<0.05).The CD45RA^+ratio,CD45RA^+count and CD45RA^+/CD45RO^+ratio of the kidney type group were(8.02 ± 3.63)%,(2.19 ± 0.33)/μL,(-0.28 ± 0.19),respectively,which were signif-icantly lower than those of the skin group [(15.74 ± 7.71)%,(2.55 ± 0.33)/μL,(0.27 ± 0.12)],the differences were statistically significant(t =3.085,2.709,4.013,all P <0.05).The ratio of CD45RA^+/CD45RO^+in the abdominal group was significantly lower than that in the skin group[(-0.07 ± 0.27)vs.(0.27 ± 0.12),t=2.989,P<0.05].Conclusion Peripheral blood T lymphocyte subsets CD45RA^+and CD45RO^+may play a role in the generation and development of immune function changes in children with HSP,and the decrease of CD45RA^+T cells may be related to the risk of HSP nephritis.