调节性B细胞在免疫性血小板减少症中的变化及意义  

Changes and significance of regulatory B cells in immune thrombocytopenia

作　　者：郝立君[1] 许腾[1] 李智伟[1] Hao Lijun;Xu Teng;Li Zhiwei(Department of Clinical Laboratory Center,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院临床检验中心,乌鲁木齐830001

出　　处：《中国医学前沿杂志（电子版）》2021年第3期112-116,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：新疆维吾尔自治区人民医院科技引进创新项目(20170306)。

摘　　要：目的探讨调节性B细胞(regulatory B cells,Breg细胞)在免疫性血小板减少症(immune thrombocytopenia,ITP)中的变化及意义。方法选取2017年1月至2020年1月新疆维吾尔自治区人民医院门诊就诊或住院初次明确诊断为ITP的31例患者纳入观察组;另选择同期于该院门诊健康体检者20例纳入对照组。ITP患者均采用大剂量地塞米松治疗。采集ITP患者治疗前后和对照组研究对象体检当日外周血2 ml,采用流式细胞仪测定CD19^(+)CD24^(^(hi))CD38^(^(hi))Breg细胞、调节性T细胞(regulatory T cells,Treg细胞)、CD19^(+)CD23^(+)B细胞和CD4^(+)CD25^(+)T细胞变化;采用酶联免疫吸附测定检测血清白介素-10(interleukin-10,IL-10)和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平。比较观察组和对照组研究对象、观察组患者治疗前和治疗后、观察组中缓解患者和无效患者外周血CD19^(+)CD24^(^(hi))CD38^(^(hi))Breg细胞表达率、Treg细胞水平、CD19^(+)CD23^(+)B细胞和CD4^(+)CD25^(+)T细胞表达率、血清IL-10和TNF-α水平。结果观察组患者外周血CD19^(+)CD24^(hi)CD38^(hi)Breg细胞表达率、CD4^(+)CD25^(+)T细胞表达率、Treg细胞水平和血清IL-10水平均显著低于对照组(均P<0.001),CD19^(+)CD23^(+)B细胞表达率和血清TNF-α水平均显著高于对照组(均P<0.001)。观察组患者治疗后外周血CD19^(+)CD24^(^(hi))CD38^(^(hi))Breg细胞表达率、CD4^(+)CD25^(+)T细胞表达率、Treg细胞水平和血清IL-10水平均显著高于本组治疗前(均P<0.001),CD19^(+)CD23^(+)B细胞表达率和血清TNF-α水平均显著低于本组治疗前(均P<0.001)。观察组中无效患者外周血CD19^(+)CD24^(hi)CD38^(hi)Breg细胞表达率、CD4^(+)CD25^(+)T细胞表达率、Treg细胞水平和血清IL-10水平均显著低于缓解患者(均P<0.001),CD19^(+)CD23^(+)B细胞表达率和血清TNF-α水平均显著高于对照组(均P<0.001)。结论ITP患者存在Breg细胞比例失衡,其变化程度与病情有关联,故而Breg细胞在Objective To investigate the changes and significance of regulatory B cells(Breg cells)in immune thrombocytopenia(ITP).Method Thirty-one outpatients or inpatients with ITP diagnosed for the first time in People's Hospital of Xinjiang Uygur Autonomous Region from January 2017 to January 2020 were selected as observation group,in addition selected 20 healthy people at the same period as control group.All ITP patients were treated with high dose dexamethasone.The 2 ml peripheral blood was collected before and after treatment in ITP patients and on the day of physical examination in control group,the changes of CD19^(+)CD24^(hi)CD38^(hi)Breg cells,regulatory T cells(Treg cells),CD19^(+)CD23^(+)B cells and CD4^(+)CD25^(+)T cells were detected by flow cytometry;the levels of interleukin-10(IL-10)and tumor necrosis factor-α(TNF-α)were measured by enzyme-linked immunosorbent assay.The expression rates of CD19^(+)CD24^(hi)CD38^(hi)Breg cells,Treg cells,expression rates of CD19^(+)CD23^(+)B cells and CD4^(+)CD25^(+)T cells,serum IL-10 and TNF-α levels in peripheral blood of patients in observation group and control group,before and after treatment in observation group,and remission and ineffective patients in observation group were compared.Result The expression rate of CD19^(+)CD24^(hi)CD38^(hi)Breg cells,CD4^(+)CD25^(+)T cells,Treg cell and serum IL-10 levels in peripheral blood of patients in observation group were significantly lower than those in control group(all P<0.001),the expression rate of CD19^(+)CD23^(+)B cells and serum TNF-α level were significantly higher than those in control group(all P<0.001).After treatment,the expression rates of CD19^(+)CD24^(hi)CD38^(hi)Breg cells,CD4^(+)CD25^(+)T cells,Treg cell and serum IL-10 levels in observation group were significantly higher than those before treatment(all P<0.001),while the expression rates of CD19^(+)CD23^(+)B cells and serum TNF-α levels were significantly lower than those before treatment(all P<0.001).The expression rate of CD19^(+)CD24^(hi)CD38^(hi)B

关 键 词：调节性B细胞 免疫性血小板减少症 发病机制 

分 类 号：R558.2[医药卫生—血液循环系统疾病]