过敏性紫癜病儿急性期外周血辅助性T淋巴细胞亚群功能的变化  

VARIATIONS OF THE FUNCTIONS OF T HELPER LYMPHOCYTE SUBSETS IN PERIPHERAL BLOOD OF CHILDREN WITH SCHONLEIN-HENOCH PURPURA IN ACUTE PHASE

作　　者：董胜英[1] 陈彤[2] 张秋业[3] 董增义[3] 雷珂[3] 

机构地区：[1]聊城市人民医院儿内科,山东聊城252000 [2]济南市第一人民医院儿科 [3]青岛大学医学院附属医院儿内科

出　　处：《齐鲁医学杂志》2004年第2期134-136,共3页Medical Journal of Qilu

摘　　要：①目的　观察过敏性紫癜 (HSP)病儿急性期外周血辅助性T细胞 (Th)亚群的功能变化 ,以探讨其在HSP发病机制中的意义。②方法　对 2 0例HSP病儿外周血单个核细胞 (PBMC)经PMA +Ca2 + 导入剂 (Ionomycin)体外诱导 4 8h ,ELISA法检测上清液中白细胞介素 4 (IL 4 )、γ 干扰素 (IFN γ)、转化生长因子 β1(TGF β1)水平。③结果　HSP病儿急性期PBMC经体外诱生IFN γ水平显著低于对照组 (t=6 .133,P <0 .0 1) ,IL 4水平显著高于对照组 (t=6 .5 4 8,P <0 .0 1) ,IFN γ/IL 4比值显著低于对照组 (t′ =5 .717,P <0 .0 1) ,TGF β1水平显著高于对照组 (t=5 .86 2 ,P <0 .0 1) ;PBMC培养上清液的TGF β1水平与IFN γ水平呈正相关 (r=0 .6 5 4 ,P <0 .0 1) ,与IL 4水平呈正相关 (r=0 .80 4 ,P <0 .0 1) ,而与IFN γ/IL 4比值呈负相关 (r =- 0 .4 5 7,P <0 .0 5 ) ;HSP病儿急性期并发肾损害组PBMC培养上清液中TGF β1、IL 4、IFN γ水平及IFN γ/IL 4比值与无肾损害组皆无显著性差异 (t或t′=0 .6 2 4～ 1.74 1,P均 >0 .0 5 )。④结论　HSP病儿急性期Th1/Th2失衡 ,呈现Th2相对优势状态 ;体内出现保护性或调节性Th3功能增强 ,但TGF β1保护性调节不足 ,使Th1/Th2失衡不能纠正 ;Objective To observe the variations of the functional states of T helper cells (Th) in peripheral blood of children with schonlein-henoch purpura(HSP) in acute phase, and to explore their roles in the pathogenesis of HSP. Methods Peripheral blood mononuclear cells(PBMC) of 20 HSP children were stimulated with PMA and ionomycin and cultured in vitro for 48 hours. The levels of interleukin-4(IL-4), interferon-γ(IFN-γ) and transforming growth factor-β 1(TGF-β 1)in the supernatants of PBMC were detected by ELISA. Results After stimulation with PMA and ionomycin, the levels of IFN-γ and the ratio of IFN-γ/IL-4 of HSP children in acute phase produced by PBMC were significantly lower than those of the controls (t or t′=6.133, 5.717, P<0.01);the levels of IL-4 and TGF-β 1 were markedly higher than those of the controls (t=6.548, 5.862, P<0.01);the levels of TGF-β 1 in the supernatants of PBMC were positively correlated with the levels of IFN-γ(r=0.654, P<0.01) and IL-4 ( r=0.804, P<0.01), but negatively correlated with the ratio of IFN-γ/IL-4(r=-0.457, P<0.05). The supernatants levels of TGF-β 1, IL-4, IFN-γ and the ratio of IFN-γ/IL-4 of HSP children in acute phase had no difference between the patients with damage of the kidney and those without (t or t′=0.624-1.741, P>0.05). Conclusion The function of Th2 relatively prevails over Th1 in HSP children. The protective or regulative function of Th3 in vivo increases, but the protective regulation of TGF-β 1 is insufficient, so the imbalance of Th1/ Th2 can not be corrected. The variation of the functional states of T helper cells in acute phase has no relationship with or without damage of the kidney.

关 键 词：过敏性紫癜 急性期 外周血 辅助性T淋巴细胞亚群 儿童 

分 类 号：R554.6[医药卫生—血液循环系统疾病]