ITP患者脾切除前后外周血Th亚群细胞因子的变化及意义  

Expression of Th cytokines in peripheral blood before and after splenectomy in immune thrombocytopenia patients

作　　者：王俊[1] 郑冬[2] 张珑涓[3] 郑朝旭[1] 

机构地区：[1]中山大学附属第一医院微创外科,广东广州510080 [2]中山大学附属第一医院血液内科,广东广州510080 [3]中山大学附属第一医院外科实验室,广东广州510080

出　　处：《中国病理生理杂志》2012年第5期901-906,共6页Chinese Journal of Pathophysiology

基　　金：广东省科技计划项目(No.2008B080703033);广东省科技计划项目(No.2010B031600212);广东省自然科学基金资助项目(No.9151008901000061)

摘　　要：目的:探讨辅助性T淋巴细胞(T helper lymphocyte,Th)亚群细胞因子在原发性免疫性血小板减少症(ITP)患者脾切除术前后的表达及意义。方法:采用QuantiGene Plex(QGP)方法检测22例ITP患者腹腔镜脾切除术前后外周血Th1(IL-2和IFN-γ)、Th2(IL-4、IL-5、IL-6和IL-10)、Th3(TGF-β1)和Th17(IL-17)细胞因子mRNA表达水平的变化。30例健康体检者作为对照组。结果:(1)术前组IL-2表达水平较对照组明显降低(P<0.05),IL-17表达水平较对照组明显升高(P<0.05),其它细胞因子表达水平在术前组和对照组之间无显著差异(P>0.05)。术后组TGF-β1表达较术前组和正常对照组均明显升高(P<0.05);术后组IL-2表达较术前有所升高(P<0.05),但仍低于对照组(P<0.05)。其它细胞因子表达水平在术前组和术后组之间无显著性差异(P>0.05)。(2)术前IL-2与IFN-γ之间成正相关(r=0.647,P<0.01),术前其它细胞因子之间均无明显相关性(P>0.05)。术后3对细胞因子之间成正相关,分别是IL-2与IFN-γ(r=0.787,P<0.01),IL-17与IL-2(r=0.554,P<0.01),IL-17与IFN-γ(r=0.461,P<0.05);术后其它细胞因子之间均无明显相关性(P>0.05)。结论:ITP患者存在Th亚群细胞因子失衡,脾切除术可改善ITP患者部分Th亚群细胞因子的失衡。AIM： To investigate the changes of Th cytokines before and after splenectomy in immune thrombocytopenia （ITP） patients. METHODS： The QuantiGene Plex method was used to measure the mRNA expression of Th1 [ interleukin - 2 （ IL - 2） and interferon - γ（ IFN - γ ], Th2 （ IL - 4, IL - 5, IL - 6 and IL - 10）, Th3 （ transforming growth factor β1, TGF - β1 ）, and Thl7 （ IL - 17 ） cytokines in peripheral blood of ITP patients before and after laparoscop- ic splenectomy and those in peripheral blood of healthy controls. RESULTS ： The mRNA level of IL - 2 was significantly decreased in ITP patients before operation compared with the healthy controls, whereas IL - 17 was obviously over - expressed. No significant difference of the other cytokines between preoperative group and the normal controls was found. After splenectomy, the expression levels of beth IL - 2 and TGF - 131 were significantly higher than those in preoperative group and the normal controls. IL- 2 was also significantly increased after operation, but was still lower than that in the normal controls. No significant difference of other cytokines between postoperative group and healthy controls was observed. In ad- dition, The Thl cytokines （ IL - 2 and IFN - γ） were found to be positively correlated （ r = 0.647, P 〈 0.01 ） in preopera- tive patients, while no correlation was found between the other cytokines. There was a positive correlation between IL -2 and IFN - γ （ r = 0. 787, P 〈 0.01 ） in postoperative patients. IL - 17 also had positive correlations with IL- 2 （ r = 0. 554,P 〈0.01 ） and IFN - γ （ r = 0. 461, P 〈 0.05 ） in ITP patients after operation, respectively. CONCLUSION： There is an imbalance of Th cytokines in ITP patients. The mechanism of splenectomy for treating ITP may be associated with the balance regulation of Th cytokines.

关 键 词：血小板减少 脾切除术 细胞因子类 辅助性T淋巴细胞 

分 类 号：R392.11[医药卫生—免疫学]