老年原发免疫性血小板减少症患者治疗前后T淋巴细胞亚群的临床研究

目的 检测老年原发免疫性血小板减少症(ITP)患者治疗前后T淋巴细胞亚群的动态变化, 探讨其在ITP发生发展中的作用。方法 采用流式细胞术测定ITP患者治疗前后及正常对照组外周血T淋巴细胞亚群的水平。结果 ITP患者治疗前后T淋巴细胞绝对值、CD3⁺、CD4⁺、CD8⁺、CD4⁺CD25⁺T淋巴细胞比例及CD4⁺/CD8⁺比值分别为(0.83±0.16)vs(1.74±0.36)、(71.71±1.07)% vs(72.69±1.35)%、(41.78±0.71)% vs(42.46±1.20)%、(29.67±0.97)% vs(28.56±1.75)%、(8.76±0.56)% vs(9.39±1.26)%、(1.42±0.07)vs(1.49±0.13), CD8⁺T淋巴细胞比例治疗后显著降低, 其余均显著升高, 差异有统计学意义(P<0.05)。结论 T淋巴细胞亚群的异常改变, 破坏自身免疫, 与病情相关, 可指导临床治疗, 并作为评估预后的参考指标。

The clinical study on T lymphocyte subsets before and after treatment in elderly patients with primary immune thrombocytopenia

Objective To detect the dynamic changes of T lymphocyte subsets before and after the treatment in elderly patients with primary immune thrombocytopenia, and to explore its role in the occurrence and development of ITP. Methods The levels of peripheral blood T lymphocyte subsets were measured before and after treatment in patients with ITP and normal control group by flow cytometry. Results Before and after treatment in patients with ITP, the absolute value of T lymphocytes, CD3⁺, CD4⁺, CD8⁺, CD4⁺CD25⁺ T lymphocyte ratio and the ratio of CD4⁺/CD8⁺ was (0.83±0.16) vs (1.74±0.36), (71.71±1.07)% vs (72.69±1.35)%, (41.78±0.71)% vs (42.46±1.20)%, (29.67±0.97)% vs (28.56±1.75)%, (8.76±0.56)% vs (9.39±1.26)%, (1.42±0.07) vs(1.49±0.13), respectively; the proportion of CD8⁺ T lymphocyte decreased significantly after the treatment; the rest were significantly increased, and the differences were statistically significant (P<0.05). Conclusion The changes of T cell subsets and the breakdown of immune are related to the course of disease, which may guide the clinical treatment and serve as a reference index to evaluate the prognosis.