ITP患者治疗前后Breg Treg构成及其相关细胞因子浓度变化和意义分析  

Changes and Significance of Breg Treg Composition and Related Cytokine Concentration in ITP Patients before and after Treatment

作　　者：郝立君[1] 许腾[1] 崔彦杰[1] 李智伟[1] HAO Lijun;XU Teng;CUI Yanjie(The People's Hospital of Xinjiang Uygur Autonomous Region,Xinjiang Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院临床检验中心,新疆乌鲁木齐830001

出　　处：《河北医学》2023年第5期756-761,共6页Hebei Medicine

基　　金：新疆维吾尔自治区自然科学基金资助项目,(编号:2021D01C152)。

摘　　要：目的:探讨免疫性血小板减少症(ITP)患者治疗前后调节性B细胞(Breg)、调节性T细胞(Treg)及其相关细胞因子水平及意义。方法:选取2018年12月至2022年1月在我院治疗的ITP患者103例作为观察组,同时选取健康志愿者103例作为对照组,检测两组Breg细胞、Treg细胞、转化生长因子-β(TGF-β)、白细胞介素-10(IL-10)、白细胞介素-4(IL-4)、白细胞介素-17(IL-17)、可溶性程序性死亡1(sPD-1)和可溶性程序性死亡配体1(sPD-L1)差异,同时分析观察组治疗前后Breg细胞、Treg细胞等差异。结果:观察组Breg细胞、Treg细胞、TGF-β、IL-10和IL-4分别为(4.46±1.01)%、(5.11±1.03)%、(2203.19±225.51)pg/mL、(4.06±0.93)pg/mL和(298.32±55.62)pg/mL,明显低于对照组(P<0.05),IL-17和sPD-1分别为(12.01±2.28)pg/mL和(110.32±19.20)pg/mL,明显高于对照组(P<0.05)。观察组和对照组sPD-L1比较差异无统计学意义(P>0.05)。观察组治疗后3个月Breg细胞、Treg细胞、TGF-β、IL-10和IL-4较治疗前升高(P<0.05),而IL-17和sPD-1较治疗前降低(P<0.05)。观察组治疗无效患者治疗前Breg细胞、Treg细胞分别为(3.88±0.97)%和(4.72±0.98)%,明显低于治疗有效患者(P<0.05);观察组治疗无效和有效患者治疗前TGF-β、IL-10、IL-4、IL-17、sPD-1和sPD-L1比较差异无统计学意义(P>0.05)。观察组治疗无效患者治疗后Breg细胞、Treg细胞和TGF-β分别为(5.68±1.01)%、(6.65±1.02)%和(2606.82±203.14)pg/mL,明显低于治疗有效患者(P<0.05),而IL-17和sPD-1为(10.11±1.60)pg/mL和(102.21±14.04)pg/mL,明显高于治疗有效患者(P<0.05)。治疗前Breg细胞、Treg细胞预测治疗有效的ROC曲线下面积分别为0.694和0.725,P<0.05。结论:ITP患者治疗前Breg细胞、Treg细胞明显降低,且相关细胞因子水平明显异常,治疗后患者Breg细胞、Treg细胞等指标明显改善,同时治疗前Breg细胞、Treg细胞在预测治疗疗效方面有一定应用价值。Objective:To investigate the levels and significance of regulatory B cells(Breg),regulatory T cells(Treg)and their related cytokines in patients with immune thrombocytopenia(ITP)before and after treatment.Methods:A total of 103 ITP patients treated in our hospital from December 2018 to January 2022 were selected as the observation group,while 103 healthy volunteers were selected as the control group,and the two groups were examined for Breg cells,Treg cells,transforming growth factor-β(TGF-β),interleukin-10(IL-10),interleukin-4(IL-4),interleukin-17(IL-17),soluble programmed death 1(sPD-1)and soluble programmed death ligand 1(sPD-L1)differences,and also analyze the differences of Breg cells and Treg cells before and after treatment in the observation group.Results:Breg cells,Treg cells,TGF-β,IL-10 and IL-4 in the observation group were(4.46±1.01)%,(5.11±1.03)%,(2203.19±225.51)pg/ml,(4.06±0.93)pg/ml and(298.32±55.62)pg/ml,respectively,which were significantly lower than those in the control group(P<0.05),IL-17 and sPD-1 were(12.01±2.28)pg/ml and(110.32±19.20)pg/ml,respectively,significantly higher than the control group(P<0.05).There was no statistically significant difference between the observation group and the control group comparing sPD-L1(P>0.05).Breg cells,Treg cells,TGF-β,IL-10 and IL-4 were higher in the observation group 3 months after treatment compared with before treatment(P<0.05),while IL-17 and sPD-1 were lower than before treatment(P<0.05).The pre-treatment Breg cells and Treg cells were(3.88±0.97)% and(4.72±0.98)%in the observation group of treatment-ineffective patients,respectively,which were significantly lower than those of treatment-effective patients(P<0.05);the differences between the comparison of pre-treatment TGF-β,IL-10,IL-4,IL-17,sPD-1 and sPD-L1 in the observation group of treatment-ineffective and effective patients were not statistically(P>0.05).The post-treatment Breg cells,Treg cells and TGF-βwere(5.68±1.01)%,(6.65±1.02)%and(2606.82±203.14)pg/ml,respectively,in th

关 键 词：免疫性血小板减少症 调节性B细胞 调节性T细胞 细胞因子 

分 类 号：R558.2[医药卫生—血液循环系统疾病]