特发性血小板减少性紫癜合并支原体感染患儿免疫功能及TGF-β1、sIL-2R水平分析  

Analysis on the immunologic functions, TGF-β1 and sIL-2R levels in children with idiopathic thrombocytopenic purpura complicated with mycoplasma infection

作　　者：杨希 焦蓉 黄薇 涂娟娟 陈丽萍 YANG Xi;JIAO Rong;HUANG Wei;TU Juan-juan;CHEN Li-ping(The First People's Hospital of Xiangyang,Xiangyang,Hubei 441000,China)

机构地区：[1]湖北省襄阳市第一人民医院儿科

出　　处：《中华医院感染学杂志》2019年第16期2515-2519,共5页Chinese Journal of Nosocomiology

基　　金：湖北省科技厅自然科学基金资助项目(EK2015D200018000803)

摘　　要：目的分析特发性血小板减少性紫癜(idiopathic thrombocytopenic purpura,ITP)合并支原体感染患儿T淋巴细胞亚群及转化生长因子-β1(transforming growth factorβ1,TGF-β1)、可溶性白细胞介素2受体(soluble interleukin 2 receptor,sIL-2R)水平,为感染相关疾病的预防和控制工作提供客观依据。方法选取2014年6月-2017年6月的40例ITP合并肺炎支原体感染患儿作为病例组,选取同期40名健康儿童作为对照组。对两组研究对象的外周血T淋巴细胞亚群及血清TGF-β1、sIL-2R水平进行检测和比较。结果病例组患儿的外周血CD3+^T淋巴细胞比例、CD4+^T淋巴细胞比例、CD4^+/CD8^+T淋巴细胞比值分别为(58.96±9.56)%、(27.21±7.73)%、(0.95±0.42)均低于对照组的(71.15±9.18)%、(42.26±10.75)%、(2.34±1.41),外周血CD8+^T淋巴细胞比例为(32.07±8.16)%高于对照组的(22.84±9.34)%(P<0.05);病例组患儿的血清sIL-2R水平为(12.98±4.23)ng/L高于对照组的(7.91±2.64)ng/L,血清TGF-β1水平为(308.82±117.53)ng/L低于对照组的(728.74±189.36)%(P<0.05);直线相关分析结果显示,ITP合并支原体感染患儿的血清TGF-β1水平与外周血CD3+^T淋巴细胞比例、CD4+^T淋巴细胞比例、CD4^+/CD8^+T淋巴细胞比值呈正相关关系(P<0.05),与外周血CD8+^T淋巴细胞比例呈负相关关系(P<0.05);血清sIL-2R水平与外周血CD3+^T淋巴细胞比例、CD4+^T淋巴细胞比例、CD4^+/CD8^+T淋巴细胞比值呈负相关关系(P<0.05),与外周血CD8+^T淋巴细胞比例呈正相关关系(P<0.05)。结论 ITP合并支原体感染患儿表现为外周血T淋巴细胞比例的失衡、血清sIL-2R水平的升高及血清TGF-β1水平的降低,且免疫指标与血清标志物指标具有相关性,ITP和支原体感染可能通过不同的信号途径共同发挥了促进疾病进展的作用。OBJECTIVE To analyze the T lymphocyte subgroups, the transforming growth factor β1(TGF-β1) and the soluble interleukin 2 receptor(sIL-2 R) levels in children with idiopathic thrombocytopenic purpura(ITP) combined with mycoplasma infection, so as to provide the objective basis for the prevention and control of infection-related diseases. METHODS Totally 40 children with ITP complicated with mycoplasma pneumoniae infection from Jun. 2014 to Jun. 2017 were selected as the case group, 40 cases of healthy children during the same period were selected as the control group. The peripheral blood T lymphocyte subgroups and the serum TGF-β1, sIL-2 R levels of the children in the two groups were detected and compared. RESULTS The CD3+^T lymphocyte percentage, the CD4+^T lymphocyte percentage and the CD4^+/CD8^+T lymphocyte ratio in the peripheral blood of the children in the case group were(58.96±9.56)%,(27.21±7.73)% and(0.95±0.42) respectively, which were lower than(71.15±9.18)%,(42.26±10.75)% and(2.34±1.41) in the control group, the peripheral blood CD8+^T lymphocyte percentage was(32.07±8.16)%, which was significantly higher than(22.84±9.34)% in the control group(P<0.05). The serum sIL-2 R level of the children in the case group was(12.98±4.23) ng/L, which was significantly higher than(7.91±2.64) ng/L in the control group, the serum TGF-β1 level was(308.82±117.53) ng/L, which was significantly lower than(728.74±189.36)% in the control group(P<0.05). Linear correlation analysis showed that the serum TGF-β1 level of the children with ITP complicated with mycoplasma pneumoniae infection was positively correlated with the CD3+^T lymphocyte percentage, the CD4+^T lymphocyte percentage, the CD4^+/CD8^+T lymphocyte ratio in the peripheral blood(P<0.05) and negatively correlated with the CD8+^T lymphocyte percentage in the peripheral blood(P<0.05). The serum TGF-β1 level was negatively correlated with the CD3+^T lymphocyte percentage, the CD4^+T lymphocyte percentage, the CD4^+/CD8^+T lymphocyte ratio in the pe

关 键 词：特发性血小板减少紫癜 支原体感染 T淋巴细胞亚群 转化生长因子-β1 可溶性白细胞介素2受体 

分 类 号：R554.6[医药卫生—血液循环系统疾病]