CD200和淋巴细胞亚群在儿童免疫性血小板减少症中的意义  

Significance of CD200 and lymphocyte subsets in Children with Immune Thrombocytopenia

作　　者：王志银[1] 汤友静 刘京硕 戴许阳 李培岭[2] WANG Zhi-yin;TANG You-jing;LIU Jing-shuo;DAI Xu-yang;LI Pei-ling(Department of Laboratory Medicine,the First Affiliated Hospital of Xinxiang Medical University,Weihui,Henan 453100,China;Department of Pediatrics,the First Affiliated Hospital of Xinxiang Medical University,Weihui,Henan 453100,China)

机构地区：[1]新乡医学院第一附属医院检验科,河南卫辉453100 [2]新乡医学院第一附属医院儿内科,河南卫辉453100

出　　处：《医药论坛杂志》2022年第23期29-32,37,共5页Journal of Medical Forum

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20200518)。

摘　　要：目的探讨CD200和淋巴细胞亚群在儿童免疫性血小板减少症(immune thrombocytopenia,ITP)发病机制中的意义。方法收集2019年4月至2021年12月新乡医学院第一附属医院收治的初诊ITP患儿40例为ITP组,选择同期来院体检的健康儿童40例为对照组。采用流式细胞术检测ITP组和对照组外周血淋巴细胞亚群、淋巴细胞上CD200表达率和Treg百分率;使用XN-2000型全自动血细胞分析仪检测血小板(PLT)计数。结果ITP组Treg百分率、PLT计数、CD4^(+)T细胞百分比、CD4^(+)/CD8^(+)比值均显著低于对照组(P<0.05);ITP组CD8^(+)T细胞百分比显著高于对照组(P<0.05);ITP组CD19^(+)B细胞百分比与对照组比较差异无统计学意义(P>0.05)。CD200在ITP组CD3^(+)T细胞上的表达率显著低于对照组(P<0.05),但两组间CD19^(+)B细胞上的CD200表达率无统计学差异(P>0.05)。Pearson相关分析显示,ITP组Treg百分率与PLT计数无相关性(r=0.138,P>0.05),但CD3^(+)T细胞上CD200表达率与PLT计数、Treg百分率分别呈正相关(r分别=0.387、0.378,P均<0.05)。结论ITP患者外周血存在CD3^(+)T细胞上CD200表达减低以及Treg、CD4^(+)/CD8^(+)T淋巴细胞亚群失衡,提示ITP的发病机制与细胞免疫失衡以及CD200表达水平的异常有关。Objective To explore the significance of CD200 and lymphocyte subsets in the pathogenesis of immune thrombocytopenia(ITP)in children.Methods Forty children with newly diagnosed ITP who admitted to the authors’hospital from April 2019 to December 2021 were selected as the ITP group,and 40 healthy children who came for physical examination during the same period were selected as the control group.The lymphocyte subsets,the expression rate of CD200 on lymphocytes and Treg percentage in peripheral blood in ITP group and control group were detected by flow cytometry.The platelet(PLT)count was measured by XN-2000 Automatic Blood Cell Analyzer.Results The Treg percentage,PLT count,CD4^(+)T cell percentage and CD4^(+)/CD8^(+)ratio in ITP group were all significantly lower and the CD8^(+)T percentage was significantly higher than those in control group(all P<0.05).There was no significant difference in the percentage of CD19^(+)B cells between the ITP group and control group(P>0.05).The expression rate of CD200 on CD3^(+)T cells in ITP group was significantly lower than that in control group(P<0.05),but there was no significant difference on CD19^(+)B cells between the two groups(P>0.05).Pearson correlation analysis showed that there was no correlation between Treg percentage and PLT count in ITP group(r=0.138,P>0.05),but the expression rate of CD200 on CD3^(+)T cells was positively correlated with PLT count and Treg percentage(r=0.387,0.378,respectively,both P<0.05).Conclusion The decreased expression of CD200 on CD3^(+)T cells and the imbalance of Treg and CD4^(+)/CD8^(+)T lymphocyte subsets were found in peripheral blood of ITP patients,suggesting that the pathogenesis of ITP is related to the imbalance of cellular immunity and abnormal expression level of CD200.

关 键 词：儿童 免疫性血小板减少症 CD200 淋巴细胞亚群 调节性T细胞 

分 类 号：R558.2[医药卫生—血液循环系统疾病]