慢性免疫性血小板减少性紫癜患者滤泡辅助性T细胞变化的研究  

Study on T follicular helper cells in patients with chronic immune thrombocytopenic purpura

作　　者：李玉珠[1] 楼瑾[1] 李明[1] 史敦云[1] 张琼丽[1] 黄德善 黄瑞宏[1] 杜新[1] 

机构地区：[1]深圳市第二人民医院血液病研究所,518035

出　　处：《白血病．淋巴瘤》2014年第8期492-494,共3页Journal of Leukemia & Lymphoma

基　　金：深圳市科技计划（201203039）

摘　　要：目的 探讨滤泡辅助性T细胞（Tfh）在成年人慢性免疫性血小板减少性紫癜（ITP）免疫发病机制中的作用.方法 采用流式细胞术检测42例慢性ITP患者治疗前后、42名健康者外周血CXCR5＋CD4＋细胞比例,采用酶联免疫吸附试验检测血浆白细胞介素（IL）-21浓度.结果 初发ITP患者组外周血中CXCR5＋CD4＋T细胞占CD4＋T细胞比例高于健康对照组[（12.15±6.82）％比（8.79±4.91）％,P＜ 0.005];经过激素治疗后,ITP患者外周血中CXCR5＋CD4＋T细胞占CD4＋T细胞比例有所下降[治疗后（9.01±5.13）％,P＜ 0.001],治疗后与健康对照组相比差异无统计学意义（P＞0.05）.初发ITP患者外周血血浆IL-21浓度高于健康对照组[（97.56±29.48） μg/ml比（30.36±12.93） μμg/ml,P＜0.001];经过激素治疗后,ITP患者外周血血浆IL-21浓度较治疗前有所下降[治疗后（67.35±20.58） μμg/ml,P＜0.001],但仍高于健康对照组（P＜ 0.001）.结论 慢性ITP患者存在Tfh细胞分布及功能异常,可能与慢性ITP的发生发展有关.Objective To investigate the role of T follicular helper （Tfh） cells in the immunepathogenesis of chronic immune thrombocytopenic purpura （ITP） of adults.Methods Forty two patients with chronic ITP and forty two healthy controls were enrolled in this study.The proportion of CD4＋ CXCR5＋ T cells of patients with ITP and healthy controls in peripheral blood were analyzed by flow cytometry.The concentration of IL-21 was detemined by ELISA.Results Compared with the healthy controls,the proportion of the relative proportion of CD4＋ CXCR5 ＋ T cells was significantly increased in patients with primary ITP,（12.15±6.82） % vs （8.79±4.91） %,P 〈 0.005,but decreased after the treatment of dexamethason for 14 days,（9.01±5.13） % vs （8.79±4.91） %,P 〉 0.001.In contrast to the healthy controls,the concentration of cytokine IL-21 was significantly elevated in patients with ITP,（97.56±29.48） μg/ml vs （30.36±12.93） μg/ml,P 〈 0.001,but the concentration of cytokine IL-21 had no significant change after the treatment of dexamethason for 14 days,（67.35 ±20.58） μg/ml vs （30.36 ±12.93） μg/ml,P 〈 0.001.Conclusion The dysfunctional proportion of Tfh cells are found in patients with chronic ITP,which might be associated with the immunopathogenesis of chronic ITP.

关 键 词：免疫性血小板减少性紫癜 滤泡辅助性T细胞 白细胞介素21 

分 类 号：R554.6[医药卫生—血液循环系统疾病]