儿童ITP外周血Th1、Th2、Th17、Treg细胞表达及临床意义  

Expression of Th1,Th17,Th22 and Treg Cells in Peripheral Blood of Children with ITP and Its Clinical Significance

作　　者：魏佩佩 方代华 WEI Pei-pei;FANG Dai-hua(Xuzhou Children's Hospital,Xuzhou 221000)

机构地区：[1]徐州市儿童医院检验科,徐州221000

出　　处：《临床输血与检验》2020年第2期168-171,共4页Journal of Clinical Transfusion and Laboratory Medicine

基　　金：徐州市科研计划项目(No.XZZD1368)资助。

摘　　要：目的 探究免疫性血小板减少性紫癜(ITP)患儿外周血Th1、Th2、Th17、Treg细胞表达水平及对临床的指导意义。方法 选取2017年6月~2018年9月于我院诊断并治疗的ITP患儿46例为病例组,以同期门诊行健康检查儿童40例为对照组。采用流式细胞术检测外周血单个核细胞中Th1、Th17、Th2、Treg细胞表达水平,采用酶联免疫方法对细胞因子IFN-γ、IL-4、IL-17检测,分析ITP患儿Th1、Th17、Th2、Treg细胞比例、细胞因子和疾病不同时期及血小板水平的关系。结果 病例组患儿外周血Th1细胞、Treg细胞频数比例、IFN-γ、IL-17水平低于对照组,Th2、Th17细胞比例、IL-4水平高于对照组,差异有统计学意义(P<0.05)。病例组治疗后患儿外周血Th1、Treg水平、血小板计数及细胞因子IL-4较治疗前升高,Th2、Th17水平及细胞因子IFN-γ、IL-17较治疗前降低,差异有统计学意义(P<0.05)。治疗前后血小板变化与外周血Treg、Th1水平呈正相关关系(r=0.461,0.383),与Th17、Th2水平呈负相关关系(r=-0.362,-0.311)。结论 本次研究表明外周血Th1、Th2、Th17、Treg细胞及细胞因子比例失衡与儿童ITP发病有关,通过测定外周血各类T淋巴细胞可初步判断疾病状态及血小板水平。Objective To explore thefrequency of Th1,Th17 and Treg cells in peripheral blood of children with ITP and its clinical significance.Methods Forty-six children with ITP diagnosed and treated in our hospital from June 2017 to September 2018 were enrolled as a case group,and 40 children in the same period were examined as health controls.The frequency of Th1,Th17,Th2 and Treg cells in peripheral blood mononuclear cells were detected by flow cytometry.The cytokines IFN-γ,IL-4 and IL-17 were detected by enzyme-linked immunosorbent assay(ELISA).The relationship between Th17,Th2,Treg cell ratio,cytokine-level and different periods of disease and platelet levels were analysed.Results The ratio of Th1 cells and Treg cells and the level of IFN-γ、IL-17 in peripheral blood of the case group were lower than that of the control group,and the proportion of Th2,Th17 and the level of IL-4 were higher than that of the control group,the difference was statistically significant(P<0.05).The levels of Th1,Treg and platelet count in peripheral blood of children in case group after treatment were higher than those before treatment,while the levels of Th2,Th17 and Th2 were lower than those before treatment,the difference was statistically significant(P<0.05).The change of platelet count before and after treatment were positively correlated with Treg and Th1 levels(r=0.461,0.383),and negatively correlated with Th17 and Th2 levels(r=-0.362,-0.311).Conclusion The unbalanced proportion of Th1,Th2,Th17,Treg cells and cytokines in peripheral blood is related to the pathogenesis of ITP in children.T lymphocytes can be used to predict disease status and platelet level.

关 键 词：免疫性血小板减少性紫癜 淋巴细胞 调节性T细胞 细胞因子 

分 类 号：R446.63[医药卫生—诊断学]