T细胞组套检测对原发性免疫性血小板减少症病情预判及治疗药物选择的指导应用  

Guiding application of T-cell immune subsets detection for condition prediction and treatment drug selection in patients with ITP

作　　者：周莉[1] 张馨慧 何柳婷 许瑾[1,3] 陆学琴 黄盼盼 徐安慧 周紫微 胡星 徐慧[1] 吴竞生[1] ZHOU Li;ZHANG Xin-hui;HE Liu-ting;XU Jin;LU Xue-qin;HUANG Pan-pan;XU An-hui;ZHOU Zi-wei;HU Xing;XU Hui;WU Jing-sheng(Department of Hematology,The First Affiliated Hospital of University of Science and Technology of China,Hefei,Anhui 230001,China;不详)

机构地区：[1]中国科学技术大学附属第一医院血液科,安徽合肥230001 [2]安徽医科大学附属省立医院血液科,安徽合肥230001 [3]皖南医学院,安徽芜湖241002

出　　处：《中国临床研究》2021年第9期1194-1198,共5页Chinese Journal of Clinical Research

基　　金：安徽省自然科学基金面上项目(2008085MH249);安徽省重点研究与开发计划项目(20194a070020094);中央校基本科研业务费专项基金资助,2019年度“科大新医学”联合基金培育项目(WK9110000138)。

摘　　要：目的观察原发性免疫性血小板减少症(ITP)患者体内免疫细胞亚群的情况,了解免疫细胞亚群对ITP疾病严重程度及治疗反应的提示作用。方法收集2018年12月至2019年9月中国科学技术大学附属第一医院收治的21例ITP及22例非ITP无免疫相关疾病患者的外周血,流式细胞仪检测免疫细胞亚群。比较两组各细胞亚群的细胞数量及比例,并结合疗效进行分析。结果ITP组的T淋巴细胞计数(CD3^(+)细胞)、CD4^(+)T淋巴细胞计数、T淋巴细胞/白细胞(CD3^(+)/CD45^(+)细胞)、CD4^(+)T淋巴细胞/白细胞(CD4^(+)/CD45^(+)细胞)、自然调节性T(nTreg)细胞(CD4^(+)CD25^(+)CD127 dim/-)计数及nTreg/CD45^(+)比值低于对照组,差异有统计学意义(P<0.01);激素治疗有效组患者的外周血nTreg细胞/CD45^(+)、nTreg/CD4^(+)与无效组比较有降低的趋势,但差异无统计学意义(P>0.05)。结论表型为CD4^(+)CD25^(+)CD127 dim/-的nTreg细胞少的ITP患者可能对激素治疗反应更好。ITP患者免疫细胞亚群检测对ITP疾病严重程度及治疗反应有提示作用,对于ITP治疗选择有一定的参考价值。Objective To observe the status of immune cell subsets in patients with primary immune thrombocytopenia(ITP),and to explore the effect of immune cell subsets on the severity assessment and guidance for the therapeutic choice of ITP patients.Methods Peripheral blood of 21 ITP patients and 22 non-ITP patients without immune related diseases treated in the First Affiliated Hospital of University of Science and Technology of China from December 2018 to September 2019 were collected,and the immune cell subsets were detected by flow cytometry.The number and proportion of each cell subsets in the two groups were compared,and the curative effect was analyzed.Results The T lymphocyte count(CD3^(+)cells),CD4^(+)T lymphocyte count,T lymphocyte/leukocyte ratio(CD3^(+)/CD45^(+)cells),CD4^(+)T lymphocyte/leukocyte ratio(CD4^(+)/CD45^(+)cells),nTreg cells count(CD4^(+)CD25^(+)CD127 dim/-)and nTreg/CD45^(+)ratio in ITP group were lower than those in control group(P<0.01).The peripheral blood nTreg cells/CD45^(+)and nTreg/CD4^(+)of patients in the effective group of hormone therapy had a decreasing trend compared with the ineffective group,but the difference was not significant(P>0.05).Conclusions ITP patients with fewer nTreg cells with a phenotype of CD4^(+)CD25^(+)CD127 dim/-may have better response to glucocorticoid therapy and are more likely to relapse.The detection of immune cell subsets in patients with ITP can indicate the severity of ITP and the response to treatment,which has a certain reference value for the choice of ITP treatment.

关 键 词：免疫性血小板减少症 调节性T细胞 淋巴细胞亚群 疾病严重程度 

分 类 号：R558.2[医药卫生—血液循环系统疾病]