T淋巴细胞亚群及血小板相关参数在儿童免疫性血小板减少症发病中的研究分析

Analysis of T lymphocyte subsets and platelet parameters in children with immune thrombocytopenia

目的:探讨T淋巴细胞亚群及血小板相关参数在儿童免疫性血小板减少症(ITP)发病中的表达及意义。方法:选取2013年6月~2015年6月唐山市妇幼保健院血液科病房收治的241例初诊ITP儿童作为观察组研究对象,另选取同期健康儿童252例作为对照组,分别检测并比较两组T淋巴细胞亚群及血小板相关参数水平,并对两组中大于4岁的儿童进行生活质量问卷调查,评估ITP患儿的生活质量。结果:观察组患儿CD3+、CD4+T淋巴细胞、CD4+/CD8+比值及PLT计数均明显低于对照组水平,而CD8+T淋巴细胞、MPV及PDW明显高于对照组水平;与治疗前水平比较,治疗5日后ITP患儿T淋巴细胞亚群及血小板相关参数水平均有明显改善;方差分析结果显示,ITP患儿血小板计数、CD4+/CD8+与骨髓巨核细胞数间差异无统计学意义;KIT生活质量问卷调查结果显示,ITP患儿治疗干预方面得分最高,为(1.89±1.06)分。结论:ITP患儿CD3+、CD4+T淋巴细胞、CD4+/CD8+比值及PLT计数均明显降低,CD8+T淋巴细胞、MPV及PDW明显升高,ITP患儿生活质量明显降低,T淋巴细胞亚群及血小板相关参数对ITP诊断具有一定的临床价值。

Objective Investigate to the expression and significance of T lymphocyte subsets and platelet parameters in children with immune thrombocytopenia. Methods From June 2013 to June 2015, 241 cases of newly diagnosed ITP children in the Department of hematology ward of Tangshan City maternal and child health hospital were selected as the observation group. Another 252 healthy children were selected as control group, and the T lymphocyte subsets and platelet related parameters were detected and compared between the two groups. The quality of life of two groups of children over the age of four years were investigated to evaluate the quality of life of children with ITP. Results The T lymphocyte of CD3+、CD4+, CD4+/CD8+ ratio and PLT count in the observation group were significantly lower than those in the control group, The T lymphocytes of CD8+, MPV and PDW were significantly higher than those in the control group; With the level before treatment, five days after treatment with ITP T lymphocyte subsets and platelet parameter levels were significantly improved; The results of variance analysis showed that there was no significant difference in platelet count, CD4+/CD8+ and the number of bone marrow megakaryocyte in children with ITP; The results of KIT quality of life questionnaire showed that ITP children had the highest score of treatment intervention, the score was(1.89±1.06). Conclusions The T lymphocyte of CD3+、CD4+, CD4+/CD8+ ratio and PLT count in children with ITP were significantly lower, the T lymphocytes of CD8+, MPV and PDW were significantly higher, the quality of life of children with ITP was significantly lower. T lymphocyte subsets and platelet parameters have some clinical value in the diagnosis of ITP.