ITP患儿APA与IVIG治疗效果、Treg细胞、Th17细胞的关系  

Relationship between APA and IVIG treatment effect,Treg cells and Th17 cells in children with ITP

作　　者：贾万理 杨阳[1] 晋婕 苏立贞 孟洁[1] 刘羡伟 高楠[4] JIA Wanli;YANG Yang;JIN Jie;SU Lizhen;MENG Jie;LIU Xianwei;GAO Nan(Department of Blood Transfusion,Xi′an High-Tech Hospital,Xi′an,Shaanxi 710075,China;Xi′an Jinyu Medical Inspection Office Co.,Ltd.,Xi′an,Shaanxi 710018,China;Department of Reproductive Medicine,Xi′an High-Tech Hospital,Xi′an,Shaanxi 710075,China;Department of Clinical Laboratory,Xi′an High-Tech Hospital,Xi′an,Shaanxi 710075,China)

机构地区：[1]西安高新医院输血科,陕西西安710075 [2]西安金域医学检验所有限公司,陕西西安710018 [3]西安高新医院生殖医学科,陕西西安710075 [4]西安高新医院检验科,陕西西安710075

出　　处：《检验医学与临床》2022年第23期3239-3241,3245,共4页Laboratory Medicine and Clinic

摘　　要：目的探讨免疫性血小板减少症(ITP)患儿抗血小板抗体(APA)与静脉注射用人免疫球蛋白(IVIG)治疗效果及Treg细胞、Th17细胞的关系。方法选择2019年1月至2021年12月西安高新医院收治的160例ITP患儿,按照APA检测结果分为APA阳性组(76例)与APA阴性组(84例),均接受IVIG治疗。比较两组患儿的治疗效果、血小板计数(PLT)、调节性T细胞与辅助性T细胞17比值(Treg/Th17细胞比值)。采用Spearman相关系数法分析APA、PLT与治疗效果、Treg细胞、Th17细胞的关系。结果治疗第14天,APA阳性组的治疗效果明显优于APA阴性组(P<0.05);APA阳性组的PLT明显高于APA阴性组(P<0.05),两组Treg细胞、Th17细胞及Treg/Th17细胞比值比较,差异无统计学意义(P>0.05)。APA与治疗效果呈正相关(r=0.472,P<0.001),与Treg细胞、Th17细胞无明显相关性(P>0.05);PLT与治疗效果、Treg细胞呈正相关(r=0.405、0.405,均P<0.001),与Th17细胞呈负相关(r=-0.412,P<0.001)。结论ITP患儿APA与IVIG治疗后Treg细胞、Th17细胞变化无关,但与治疗效果存在相关性,可能成为ITP患儿IVIG治疗效果的预测指标。Objective To discuss the relationship between anti-platelet antibody(APA)and the therapeutic effect of intravenous immunoglobulin(IVIG),Treg cells and Th17 cells in children with immune thrombocytopenia(ITP).Methods A total of 160 children with ITP admitted to Xi′an High-Tech Hospital from January 2019 to December 2021 were selected and divided into APA positive group(76 cases)and APA negative group(84 cases)according to APA test results,all of whom received IVIG treatment.The treatment effect,platelet count(PLT),and the ratio of regulatory T cells to T helper cells(Treg/Th17 cells)were compared between the two groups.Spearman correlation coefficient method was used to analyze the relationship between APA,PLT counts and therapeutic effect,Treg/Th17 cells.Results On the 14th day of treatment,the therapeutic effect of APA positive group was significantly better than that of APA negative group(P<0.05).The PLT of APA positive group was significantly higher than that of APA negative group(P<0.05),and there was no significant differences in Treg cells,Th17 cells and Treg/Th17 cells between the two groups(P>0.05).APA positively correlated with the therapeutic effect(r=0.472,P<0.001),but not with Treg cells and Th17 cells(P>0.05).PLT positively correlated with treatment effect and Treg cells(r=0.405,0.405,both P<0.001),and negatively correlated with Th17 cells(r=-0.412,P<0.001).Conclusion APA in children with ITP doesn′t correlated with Treg cells and Th17 cell changes after IVIG treatment,but correlated with treatment effect,which might be a predictor of IVIG treatment effect in children with ITP.

关 键 词：免疫性血小板减少症 抗血小板抗体 静脉注射 免疫球蛋白 TREG细胞 TH17细胞 相关性 

分 类 号：R725.5[医药卫生—儿科]