重组人白细胞介素11对特发性血小板减少性紫癜患者Th1／Th2和T-bet／GATA-3失衡的影响  

Effect of rhIL-11 on Th1/Th2 and T-bet/GATA-3 imbalance in idiopathic thrombocytopenic purpura

作　　者：马红玲 贺永春 刘艳芳 徐志鹏 李亚琦 赵娟 

机构地区：[1]山西省大同市第二人民医院肿瘤医院大同市肿瘤医院血液科,037000

出　　处：《中国综合临床》2018年第1期59-63,共5页Clinical Medicine of China

摘　　要：目的探讨重组人白细胞介素（recombinant human interleukin，rhIL）11治疗特发性血小板减少症（idiopathic thrombocytopenic purpura，ITP）对Thl、Th2水平及其转录因子T-bet mRNA、GATA-3 mRNA表达水平的影响。方法收集2015年5月至2016年12月在大同市第二人民医院血液科住院治疗的成人ITP患者，共56例，男21例，女35例；年龄29～73岁；我院同期体检健康人10名为对照组，男4名，女6名；年龄20～52岁。使用rhIL-11治疗ITP患者，流式细胞仪检测治疗前后Th1、Th2细胞比例及Th1/Th2比值；实时荧光定量逆转录-多聚酶链反应（RT-PCR）分析转录因子T-bet和GATA-3 mRNA表达。结果rhIL-11治疗ITP有效率为76.8%（43/56）。对于有效的患者，治疗后PLT中位数明显升高为[25.0（15.0，36.0）]×109/L与[68.0（49.0，108.0）]×109/L（Z＝－5.712，P〈0.001）；Th1细胞较治疗前下降[14.8%（12.6%，17.6%）与10.6%（9.8%，12.6%），Z＝－4.825，P〈0.001]；Th2细胞水平较治疗前升高[0.4%（0.3%，0.5%）与1.2%（0.9%，1.4%），Z＝－5.720，P〈0.001]；Th1/Th2治疗后比治疗前明显降低[40（30，49）与10.6（7.8，12.0），Z＝－5.711，P〈0.001]；T-bet mRNA表达水平较治疗前下降[0.36（0.18，0.51）与0.09（0.05，0.13），Z＝－2.668，P＝0.008]；GATA-3 mRNA表达水平较治疗前升高[0.04（0.03，0.05）与0.12（0.09，0.15），Z＝－2.366，P＝0.018]。对于无效的患者，治疗前PLT中位数为11.0（8.0，15.5）×109/L，治疗后PLT中位数为15.0（10.0，19.5）×109/L（Z＝－3.027，P＝0.002）；ITP患者治疗前后Th1、Th2细胞水平、Th1/Th2比率以及T-bet和GATA-3 mRNA的表达水平差异无统计学意义（P均〉0.05）。结论rhIL-11可有效纠正ITP患者体内Th1、Th2细胞失衡，及其相应的调控因子T-bet、GATA-3的失衡；但对少部分患者无明显的治疗作用。ObjectiveTo investigate the effect of recombinant human interleukin 11 （rhlL-11） in the treatment of idiopathic thrombocytopenic purpura （ITP） on the levels of Th1, Th2 and the expression of their transcription factors T-bet mRNA, GATA-3 mRNA.MethodsFifty-six cases adult ITP patients hospitalized in the department of hematology of the Second People’s Hospital of Datong from May 2015 to December 2016 were collected, including 21 males and 35 females, aged 29~73 years; 10 healthy people in the same period were enrolled as control group, 4 males and 6 females, aged 20~52 years.Th1 and Th2 cell ratio and Th1/Th2 ratio of ITP patients were detected by flow cytometry before and after treatment.The expression levels of transcription factor T-bet and GATA-3 were measured using real-time fluorescence quantitative reverse transcription polymerase chain reaction （RT-PCR） before and after treatment.ResultsThe effective rate of rhlL-11 in ITP treatment was 76.8%（43/56）. For the effective patients, the median PLT after treatment increased （25.0 （15.0, 36.0）×109/L vs.68.0 （49.0, 108.0）×109/L, Z=-5.712, P〈0.001）; Th1 cells decreased, compared with that before the treatment （14.8 % （12.6%, 17.6%） vs.10.6 % （9.8%, 12.6%）, Z=-4.825, P〈0.001）; Th2 cell increased, compared with that before the treatment （0.4% （0.3%, 0.5%） vs.1.2 % （0.9%, 1.4%）, Z=-5.720, P〈0.001）; Th1/Th2 decreased, compared with that before the treatment（40 （30, 49） vs.10.6 （7.8, 12.0）, Z=-5.711, P〈0.001]; the expression level of T-bet mRNA decreased （0.36 （0.18, 0.51） vs 0.09 （0.05, 0.13）, Z=-2.668, P=0.008）; the expression level of GATA-3 mRNA increased, compared with that before treatment （0.04 （0.03, 0.05） vs.0.12 （0.09, 0.15）, Z=-2.366, P=0.018）. For ineffective patients, the median PLT before treatment was （11.0 （8.0, 15.5）×109/L）, and the median PLT after treatment was （15.0 （10.0, 19.5）×109/L） （Z=-3.027, P=0.002）; there was no significant d

关 键 词：特发性血小板减少症 重组人白细胞介素11 辅助性T细胞1 辅助性T细胞2 T-bet转录因子 GATA-3转录因子 

分 类 号：R554.6[医药卫生—血液循环系统疾病]