ITP患儿免疫球蛋白、淋巴细胞亚群及Th17/Treg的表达分析  

Expression analysis of immunoglobulin,lymphocyte subsets and Th17/Treg in children with ITP

作　　者：黄宝山 徐佳丽 姜帅 李蓉 张林美 李莉 HUANG Baoshan;XU Jiali;JIANG Shuai;LI Rong;ZHANG Linmei;LI Li(Xuzhou Children’s Hospital,Xuzhou,Jiangsu 221000,China;The Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221000,China)

机构地区：[1]江苏省徐州市儿童医院,221000 [2]徐州医科大学附属医院,江苏徐州221000

出　　处：《重庆医学》2022年第17期2961-2965,共5页Chongqing medicine

基　　金：江苏省卫生和计划生育委员会科研项目(H2017082)。

摘　　要：目的探究免疫性血小板减少性紫癜(ITP)患儿血小板相关免疫球蛋白(PAIg)、淋巴细胞亚群及辅助性T细胞(Th)17/调节性T细胞(Treg)表达情况及其临床价值。方法回顾性分析2018年9月至2021年9月徐州市儿童医院收治的92例ITP患儿作为病例组,另根据患儿性别、年龄为配伍原则,选取同期84例健康体检儿童为对照组。比较两组PAIg(PAIgG、PAIgA、PAIgM)、淋巴细胞亚群(CD3、CD4、CD8、CD19、CD16、CD56)及Th17/Treg水平,以Pearson相关性分析PAIg、淋巴细胞亚群及Th17/Treg的相关性,以受试者工作特征(ROC)曲线评估PAIg、淋巴细胞亚群及Th17/Treg对ITP患儿的预测价值。结果与对照组比较,病例组PAIgG、PAIgA、PAIgM、CD8、CD19水平更高,CD3、CD4、CD4/CD8、CD16+CD56、Th17、Treg及Th17/Treg水平更低,差异有统计学意义(P<0.05)。Pearson相关性显示,PAIgG、PAIgA、PAIgM、CD8、CD19与Th17、Treg均呈负相关,CD3、CD4、CD4/CD8、CD16+CD56与Th17、Treg、Th17/Treg均呈正相关(P<0.05)。ROC曲线显示,PAIgG、PAIgA、PAIgM、CD3、CD4、CD8、CD4/CD8、CD19、CD16+CD56、Th17、Treg及Th17/Treg诊断ITP的曲线下面积分别为0.849、0.889、0.856、0.851、0.772、0.846、0.949、0.956、0.750、0.801、0.732、0.762,均具有一定准确性。结论ITP患儿血小板减少可能与PAIg、淋巴细胞亚群改变及Th17/Treg失衡有关。Objective To explore the expression status and its clinical value of platelet-associated immunoglobulin(PAIg),lymphocyte subsets and helper T cells(Th)17/regulatory T cells(Treg)in children with immune thrombocytopenic purpura(ITP).Methods A total of 92 children with ITP admitted to hospital from September 2018 to September 2021 was selected as the case group.In addition,based on the gender and age of the children as compatibility principles,84 children with healthy physical examination during the same period were selected as the control group.The levels of PAIg(PAIgG,PAIgA,PAIgM),lymphocyte subgroups(CD3,CD4,CD8,CD19,CD16,CD56)and Th17/Treg between the two groups of children were compared.The correlation between PAIg,lymphocyte subgroups and Th17/Treg were analyze to use Pearson correlation,and the receiver operating characteristic(ROC)curve was used to evaluate the predictive value of PAIg,lymphocyte subgroups and Th17/Treg in children with ITP.Results Compared with the control group,the values of PAIgG,PAIgA,PAIgM,CD8,CD19 were higher in the case group,and the levels of CD3,CD4,CD4/CD8,CD16+CD56,Th17,Treg and Th17/Treg were lower in the case group,and the difference was statistically significant(P<0.05).Pearson correlation showed that PAIgG,PAIgA,PAIgM,CD8,CD19 were negatively correlated with Th17,Treg;CD3,CD4,CD4/CD8,CD16+CD56 were positively correlated with Th17,Treg,Th17/Treg(P<0.05).ROC curve results showed that the area under curve of PAIgG,PAIgA,PAIgM,CD3,CD4,CD8,CD4/CD8,CD19,CD16+CD56,Th17,Treg and Th17/Treg to diagnose ITP were 0.849,0.889,0.856,0.851,0.772,0.846,0.949,0.956,0.750,0.801,0.732,0.762 respectively,all with certain accuracy.Conclusion Thrombocytopenia in children with ITP may be related to changes in PAIg,lymphocyte subgroups and Th17/Treg imbalance.

关 键 词：免疫性血小板减少性紫癜 血小板相关免疫球蛋白 淋巴细胞亚群 TH17/TREG 免疫反应 

分 类 号：R725.5[医药卫生—儿科]