血小板输注无效患者外周血T、B、NK细胞和血小板抗体表达  

Changes of platelet specific autoantibody,T,B,NK cells in patients with platelet transfusion refractoriness

作　　者：张玲[1] 孙庆正 王晓珍[1] 刘加军[1] ZHANG Ling;SUN Qingzheng;WANG Xiaozhen;LIU Jiajun(Department of Hematology,The Third Affifiliated Hospital of Sun Yat-sen University,Guangzhou,Guangdong,China,510630)

机构地区：[1]中山大学附属第三医院血液内科,广东广州510630

出　　处：《分子诊断与治疗杂志》2022年第12期2163-2165,2170,共4页Journal of Molecular Diagnostics and Therapy

基　　金：广东省重点领域研发计划项目(2022B1111020003)。

摘　　要：目的测定血小板输注无效患者外周血中T、B、NK细胞比例以及血小板特异性抗体表达,探讨其在血小板输注无效中的作用。方法选择中山大学附属第三医院血液内科住院的22例血小板输注无效的患者,同时选取33例血小板输注有效的患者作为对照组,通过流式细胞术检测两组患者外周血中B细胞,NK细胞,T细胞比例,同时采用固相凝集法测定血小板特异性抗体。结果无效组血小板特异性抗体阳性率明显高于血小板输注有效组,差异有统计学意义(86.36%vs 15.15%,x^(2)=27.22,P<0.05);在淋巴细胞亚群变化中,相对于有效组,无效组B淋巴细胞比例升高,CD3^(+)CD4^(+)T淋巴细胞比例下降,CD3^(+)CD8^(+)T淋巴细胞比例升高,CD4^(+)/CD8^(+)比值下降,CD3^(+)T淋巴细胞和NK细胞比例差异无统计学意义(t=1.864,0.05185,P>0.05)。结论血小板特异性抗体的产生及淋巴细胞亚群的变化在血小板输注无效的发生过程中发挥重要作用,有助于指导临床治疗。Objective To detect the proportion of T,B,NK cells and platelet antibody in the peripheral blood of patients with platelet transfusion refractoriness(PTR),and to explore their possible role in PTR.Methods 22 patients with PTR admitted to the Department of Hematology,the Third Affiliated Hospital of Sun Yat⁃Sen University were chosen as case group and 33 patients without PTR were control group.The proportion of T,B,NK cells in the peripheral blood of patients in both groups were detected by flow cytometry,and the platelet specific antibody in the serum of which were detected by solid phase agglutination method.Results The positive rate of platelet antibody in the case group was significantly higher than that in the control group(86.36%vs 15.15%,x^(2)=27.22,P<0.05);For the aspect of lymphocyte subsets changes,the proportion of B cells increased in the case group,while the proportion of CD3^(+)CD4^(+)T cells decreased,the proportion of CD3^(+)CD8^(+)T cells increased,the proportion of CD4^(+)/CD8^(+) decreased.There was no significant difference in the proportion of NK cells and CD3^(+)T cells between two groups.Conclusion The generation of platelet specific antibody and lymphocyte subsets changes play an important role in the pathogenesis of PTR,and will provide promising references for the treatment strategies of PTR patients.

关 键 词：血小板输注无效 血小板特异性抗体 T/B/NK细胞 

分 类 号：R457.1[医药卫生—治疗学]