外周血T淋巴细胞亚群变化与原发性免疫性血小板减少症患儿IVIG疗效的相关性  

Peripheral blood T lymphocyte subset changes and the correlation between the efficacy of IVIG in children with primary immune thrombocytopenia

作　　者：罗信国[1] 叶虹位 施方静 胡姗姗 许维东[2] LUO Xin-guo;YE Hong-wei;SHI Fang-jing;HU Shan-shan;XU Wei-dong(Department of Hematology,Jinhua People's Hospital,Jinhua,Zhejiang 321000,China;不详)

机构地区：[1]金华市人民医院血液科,浙江金华321000 [2]金华市人民医院检验科

出　　处：《中国妇幼保健》2025年第2期239-242,共4页Maternal and Child Health Care of China

基　　金：浙江省医学会临床研究科研资金项目(2017ZYC-A104);浙江省金华市科学技术研究计划项目(2021-4-075)。

摘　　要：目的探讨人免疫球蛋白(IVIG)治疗原发性免疫性血小板减少症(ITP)患儿的疗效与T淋巴细胞亚群变化水平的相关性。方法选择2020年1月—2023年6月在金华市人民医院接受治疗的ITP患儿80例,按照随机数字表法分为观察组(40例)和对照组(40例)。观察组给予IVIG治疗,对照组给予泼尼松治疗。比较两组的疗效、血小板计数及T淋巴细胞亚群变化情况,探讨观察组患儿血小板计数与T淋巴细胞亚群变化水平的相关性。结果与对照组的总有效率(75.00%)比较,观察组的总有效率(92.50%)明显升高,差异有统计学意义(P<0.05)。两组血小板计数在治疗后与治疗前比较均有所升高,且治疗后观察组血小板计数与对照组比较显著升高(P<0.05)。与治疗前比较,两组治疗后外周血CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)比值升高,CD8^(+)降低;且观察组治疗后CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)比值高于对照组,CD8^(+)低于对照组(P<0.05)。观察组患儿血小板计数与CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)呈正相关(r=0.674、0.722、0.691,均P<0.05),与CD8^(+)呈负相关(r=-0.647,P<0.05)。结论外周血T淋巴细胞亚群变化与原发性ITP患儿IVIG疗效存在密切联系,T淋巴细胞亚群比例平衡有助于升高患儿血小板计数,提高治疗效果。Objective To explore the correlation between the efficacy of intravenous immunoglobulin(IVIG)in children with primary immune thrombocytopenia(ITP)and the level of T lymphocyte subset changes.Methods A total of 80 ITP pediatric patients treated in Jinhua People's Hospital from January 2020 to June 2023 were selected and randomly assigned into two groups:the observation group(n=40)and the control group(n=40),utilizing a random number table for the division.The observation group was given IVIG treatment,and the control group was given prednisone treatment.The efficacy of the two groups was compared,the platelet count and T lymphocyte subset changes of the two groups were compared,and the correlation between the platelet count and T lymphocyte subset changes of the observation group was explored.Results There was a marked increase in the total efficacy rate in the observation group(92.50%)compared to that in the control group(75.00%),and this difference was statistically significant(P<0.05).Compared with before treatment,the platelet count in both groups has improved,and the platelet count of the observation group improved significantly after treatment compared with the control group(P<0.05).Compared with before treatment,The T lymphocyte subsets CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)in both groups has improved,and the T lymphocyte subsets of the observation group improved significantly after treatment compared with the control group(P<0.05).The platelet count of the observation group was positively correlated with CD3^(+),CD4^(+),CD4^(+)/CD8^(+)(r=0.674,0.722,0.691,P<0.05),and negatively correlated with CD8^(+)(r=-0.647,P<0.05).Conclusion Peripheral blood T lymphocyte subset changes are closely related to the efficacy of IVIG in children with primary ITP,and the balance of T lymphocyte subset ratio is helpful to increase platelet count and improve therapeutic effect.

关 键 词：原发性免疫性血小板减少症 人免疫球蛋白 疗效 T淋巴细胞亚群 血小板计数 

分 类 号：R558.2[医药卫生—血液循环系统疾病]