滤泡辅助性T细胞亚群在慢性特发性血小板减少性紫癜患儿发病机制中的作用分析  

Cell immune function change of children with chronic ITP and its clinical significance

作　　者：黄德善 李玉珠[1] 张琼丽[1] 史敦云[1] 楼瑾[1] 张巧霞[1] 李明[1] 杜新[1] Huang Deshan;Li Yuzhu;Zhang Qiongli;Shi Dunyun;Lou Jin;Zhang Qiaoxia;Li Ming;Du Xin(Institute of Hematology,Shenzhen Sec-ond People's Hospital,Guangdong 518035,China)

机构地区：[1]深圳市第二人民医院血液病研究所,518035

出　　处：《山西医药杂志》2019年第1期20-22,共3页Shanxi Medical Journal

基　　金：深圳市科技计划项目(20120309)

摘　　要：目的探索滤泡辅助性T细胞(Tfh)在慢性特发性血小板减少性紫癜(ITP)患儿中的作用机制。方法用流式细胞术检测38名健康儿童、35例ITP患儿外周血CXCR5+CD4+T细胞占CD4+T细胞的比例。采用酶联免疫吸附试验检测健康儿童、ITP患儿血浆白细胞介素-21(IL-21)浓度。结果与健康对照组相比,ITP患儿外周血CXCR5+CD4+T细胞占CD4+T细胞的比例显著增高[(13.86±7.53)%,(7.65±5.36)%,P<0.05]。经过激素治疗后,ITP患儿外周血中CXCR5+CD4+T细胞占CD4+T细胞比例有所下降[(13.8±0.41)%,(8.23±6.12)%,P<0.05]。初发ITP患儿外周血血浆IL-21浓度显著高于健康对照组[(80.47±25.79)μg/mL,(32.41±17.53)μg/mL,P<0.05]。经过激素治疗后,ITP患儿外周血血浆IL-21浓度有所下降,但两者差异无统计学意义[(80.47±25.79)μg/mL,(60.35±19.54)μg/mL,P>0.05]。结论慢性ITP患儿与健康对照组相比,存在Tfh细胞数量及功能异常,可能与慢性ITP的发病相关。Objective To investigate the expression of the T follicular helper cells(Tfh)in peripheral blood of children with immune thrombocytopenic purpura(ITP).Methods Thirty-five children with ITP and 38 healthy chil-dren(control group)were enrolled in this study.The proportion of CXCR5^+CD4^+T cells of children with ITP and healthy controls in peripheral blood were analyzed by flow cytometry.The concentration of plasma IL-21 was deter-mined by ELISA.Results The ratio of CXCR5^+CD4^+T cells in ITP children is significantly higher than that in the control group[(13.86±7.53)%vs(7.65±5.36)%,P<0.05],but decreased after the treatment of dexamethason for 30 days[(13.8±0.41)%vs(8.23±6.12)%P<0.05].In contrast to the healthy controls,the concentration of cytokine IL-21 was significantly elevated in patients with ITP[(80.47±25.79)pig/mL vs(32.41±17.53)pig/mL P<0.05],but there is no significant change of cytokine IL-21 after the treatment of dexamethason for 30 days[(80.47±25.79)pig/mL vs(60.35±19.54)pig/mL P>0.05].Conclusion The ratio of Tfh increased in ITP patients.Tfh might play a role in evaluation and treatment of ITP.

关 键 词：紫癜 血小板减少性 特发性 滤泡辅助性T细胞 白细胞介素21 

分 类 号：R725.5[医药卫生—儿科]