慢性特发性血小板减少性紫癜患者在氟美松或静脉注射人免疫球蛋白治疗后体内细胞因子谱的变化  

The changes of Cytokine profile in patients with chronic idiopathic thrombocytopenic purpura after treatment with DXM and/or IVIG

作　　者：薛峰[1] 刘敏[1] 赵辉[1] 李洪强[1] 季林祥[1] 赵艳津[1] 卢士红[1] 杨仁池[1] 

机构地区：[1]中国医学科学院北京协和医学院血液学研究所血液病医院,天津300020

出　　处：《国际输血及血液学杂志》2007年第6期487-490,共4页International Journal of Blood Transfusion and Hematology

基　　金：国家自然科学基金（30670900）、教育部高等院校博士点基金（20060023031）和2006年度人事部留学回国人员科技活动择优资助项目（优秀娄）部分瓷助

摘　　要：目的研究慢性特发性血小板减少性紫癜（CITP）患者经氟美松或静脉注射用人免疫球蛋白治疗后辅助性T细胞（Th）细胞因子谱的变化。方法对CITP、系统性红斑狼疮伴有血小板减少（SLETP）、再生障碍性贫血（AA）患者及正常对照分别用ELISA及RIA方法测定细胞因子谱。用RT—PCR检测辅助性T细胞相关的转录因子c-Mar及T-bet。结果经氟美松和／或静脉注射人免疫球蛋白治疗的CITP患者均取得了良好的反应，体内IL-2水平显著低于正常对照。但是Th2细胞因子IL-4水平显著高于正常对照。用PHA对CITP患者外周血单个核细胞（PBMC）刺激后，IL-13的分泌量明显增高，而正常对照PBMC受刺激后IL-13水平很低。结论CITP患者经氟美松／静脉注射人免疫球蛋白治疗后倾向于Th2细胞因子分泌，这可能是患者获得病情缓解的机制之一。Objective To determine the T helper cell cytokine profile in patients with chronic idiopathic thrombocytopenia purprua （CITP） receiving dexamethasone （DXM） and/or intravenous immunoglobulin （IVIG）. Methods By means of ELISA and RIA, cytokine profile in patients with CITP, systemic lupus erythematosus with thrombocytopenia （SLE-TP） and aplastic anemia （AA）, and normal controls were assayed respectively. In the meantime, RT-PCR was performed to explore the T helper cellassociated transcript factors, e.g. c-Mar and T-bet. Results After DXM and/or IVIG treatment, all the （TITP patients showed a good response and IL-2 level in CITP patients was significant lower than that in the normal controls, however, Th2-1ike cytokine, IL-4 was significant higher in patients than in normal controls. On stimulation with PHA, significant higher secretion of IL-13 was found in PBMC from patients with CITP, whereas PBMC in normal controls showed very low levels of IL-13. Conclusions After DXM/IVIG treatment, CITP patients skewed to Th2-1ike cytokine pattern, and this might be the mechanism of the amelioration of ITP.

关 键 词：特发性血小板减少性紫癜 辅助性T细胞 细胞因子 

分 类 号：R5[医药卫生—内科学]