免疫性血小板减少症脾切除疗效与外周血Th亚群细胞因子表达的关系  

Relationship between the hematological outcomes of splenectomy and the expression of Th cytokines of peripheral blood in ITP patients

作　　者：郑冬[1] 张珑涓[2] 汪谦[3] 王俊[3] 黄晨松 郑朝旭[3] 

机构地区：[1]中山大学附属第一医院血液内科,广州510080 [2]中山大学附属第一医院外科实验室,广州510080 [3]中山大学附属第一医院普通外科,广州510080

出　　处：《中华普通外科学文献（电子版）》2014年第2期27-31,共5页Chinese Archives of General Surgery(Electronic Edition)

基　　金：广东省科技计划项目(2010B031600212;2012B031800284)

摘　　要：目的探讨原发性免疫性血小板减少症(ITP)脾切除血液学疗效与外周血辅助性T细胞(Th)亚群细胞因子的mRNA表达水平的关系。方法采用QuantiGene Plex(QGP)方法,分别检测14例手术有效(R组)和8例手术无效(NR组)的ITP患者腹腔镜脾切除术前后外周血Th1(IL-2、IFN-γ)、Th2(IL-4、IL-5、IL-6、IL-10)、Th3(TGF-β1)、Th17(IL-17)细胞因子的mRNA表达水平的变化。对照组为30例健康体检者。结果术前及术后R组TGF-β1mRNA的表达水平均明显高于NR组(P值分别为0.001和0.006)及对照组(P值分别为0.001和<0.001)。术前及术后R组和NR组之间IL-2、IFN-γ与IL-17 mRNA的表达水平差异均无统计学意义。结论脾切除疗效不同的ITP患者TGF-β1的mRNA表达水平存在差异,检测术前TGF-β1的表达水平有助于预测手术疗效。Objective To investigate the relationship between the hematological outcomes of splenectomy and the mRNA expressions of Th cytokines in primary immune thrombocytopenia （ITP） patients. Methods The mRNA expression of Th1 （IL-2,IFN-γ）, Th2 （IL-4,IL-5,IL-6,IL-10）, Th3 （TGF-β1）, and Th17 （IL-17） cytokines in peripheral blood before and after laparoscopic splenectomy were detected by the QuantiGene Plex method from fourteen cases of responder group （Group R） and eight cases of non-responder group （Group NR）. Thirty healthy subjects were served as the control group. Results TGF-β1 mRNA expressions before and after splenectomy in Group R were significantly higher than those in Group NR （P values were 0.001 and 0.006, respectively） and control group （P values were 0.001 and〈0.001, respectively）. No significant differences of IL-2, IFN-γand IL-17 mRNA expression before or after splenectomy between Group R and Group NR were observed. Conclusions There are different TGF-β1 mRNA expressions in ITP patients with different responses to splenectomy. Preoperative detection of TGF-β1 expression is helpful to predict the outcome of surgery.

关 键 词：免疫性血小板减少症 脾切除术 细胞因子 

分 类 号：R657.6[医药卫生—外科学]