老年原发免疫性血小板减少症免疫细胞亚群的表达及临床意义  

Expression and clinical significance of immune cell subsets in elderly patients with primary immune thrombocytopenia

作　　者：包维莺[1] 范燕琴 刘媛[1] 范璐 柯金 王恒石 朱锐锋 肖素芳 张善兰 胡喜梅[1] BAO Weiying;FAN Yanqin;LIU Yuan;FAN Lu;KE Jin;WANG Hengshi;ZHU Ruifeng;XIAO Sufang;ZHANG Shanlan;HU Ximei(Department of Hematology,the Songjiang Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 201699,P.R.China)

机构地区：[1]上海交通大学医学院附属松江医院(筹)血液科,上海201699

出　　处：《华西医学》2022年第5期733-737,共5页West China Medical Journal

基　　金：上海市松江区科学技术攻关项目(14sjggyy12)。

摘　　要：目的 研究治疗前后老年原发免疫性血小板减少症(immune thrombocytopenia,ITP)患者T淋巴细胞亚群、自然杀伤(natural killer,NK)细胞及CD19^(+)B细胞表达水平和临床意义。方法 回顾性选择2014年1月—2019年6月上海交通大学医学院附属松江医院(筹)诊治的老年ITP患者作为观察组,并选择同期健康老年体检者为对照组。根据治疗情况,将观察组分为治疗有效组和治疗无效组。观察分析其T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、NK细胞及CD19^(+)B细胞表达水平。结果 观察组共纳入患者35例,治疗总有效率85.71%(30/35)。对照组共纳入健康体检者40例。治疗前,观察组的T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))表达水平均低于对照组(P<0.05);其余指标两组比较,差异均无统计学意义(P>0.05)。治疗后,除CD8^(+)外(P>0.05),观察组的T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))表达水平均高于治疗前(P<0.05);NK细胞和CD19^(+)B细胞表达水平均低于治疗前(P<0.05)。治疗有效组的T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))表达水平均高于治疗前(P<0.05),CD19^(+)B细胞表达水平则低于治疗前(P<0.05);其余指标治疗前后比较,差异均无统计学意义(P>0.05)。治疗无效组的T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、NK细胞及CD19^(+)B细胞表达水平治疗前后比较,差异均无统计学意义(P>0.05)。结论 T淋巴细胞亚群在老年ITP患者中存在异常,T淋巴细胞的免疫异常可能是老年ITP患者致病的原因之一,随疗效的改善免疫细胞亚群也得到一定改善。Objective To investigate the expression and clinical significance of T lymphocyte subsets,natural killer(NK) cells and CD19^(+) B cells in the elderly with primary immune thrombocytopenia(ITP) before and after treatment.Methods The elderly ITP patients diagnosed and treated in the Songjiang Hospital Affiliated to Shanghai Jiaotong University School of Medicine(preparatory stage) between January 2014 and June 2019 were retrospectively selected as the observation group.The healthy elderly in the same period were selected as the control group.According to the treatment,the observation group was divided into effective group and ineffective group.The expression levels of T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+) and CD4^(+)/CD8^(+)),NK cells and CD19^(+) B cells were observed and analyzed.Results A total of 75 subjects were included,including 35 in the observation group and 40 in the control group.The total effective rate was 85.71%(30/35).Before treatment,the expression levels of T lymphocyte subsets(CD3^(+),CD4^(+) and CD4^(+)/CD8^(+)) in the observation group were lower than those in the control group(P<0.05).There was no significant difference in other indexes between the two groups(P>0.05).After treatment,except for CD8^(+),the expression levels of T lymphocyte subsets(CD3^(+),CD4^(+) and CD4^(+)/CD8^(+)) in the observation group were higher than those before treatment(P<0.05).The expression levels of NK cells and CD19^(+) B cells were lower than those before treatment(P<0.05).The expression levels of T lymphocyte subsets(CD3^(+),CD4^(+) and CD4^(+)/CD8^(+)) in the effective group were higher than those before treatment(P<0.05),while the expression level of CD19^(+) B cells was lower than that before treatment(P<0.05).There was no significant difference in other indexes before and after treatment(P>0.05).There was no significant difference in the expression levels of T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+) and CD4^(+)/CD8^(+)),NK cells and CD19^(+)B cells in the ineffective group before and after treatmen

关 键 词：原发免疫性血小板减少症 老年患者 T淋巴细胞亚群 自然杀伤细胞 CD19^(+)B细胞 

分 类 号：R558.2[医药卫生—血液循环系统疾病]