细胞凋亡和增殖在特发性血小板减少性紫癜中的作用

目的为了探讨特发性血小板减少性紫癜(ITP)患者外周血淋巴细胞凋亡的特征和抗凋亡的bcl-xl蛋白及p65的变化情况以及肾上腺糖皮质激素治疗对其的影响.方法采用肾上腺糖皮质激素治疗的ITP患者,取静脉血标本,用原位细胞凋亡(TUNEL染色)来检测外周血淋巴细胞凋亡情况;免疫组化方法检测bcl-xl蛋白、p65,检测淋巴细胞抗凋亡的增殖能力.结果 ITP患者,肾上腺糖皮质激素治疗前外周血淋巴细胞凋亡明显减少,凋亡指数下降;治疗达到缓解后,淋巴细胞凋亡明显增多,凋亡指数上升,TUNEL染色阳性细胞明显增多;bcl-xl蛋白、p65在DEX治疗前是升高的,治疗后显著下降(P<0.05);凋亡指数与bcl-xl、p65呈负相关.结论 ITP患者淋巴细胞凋亡和增殖的异常是ITP发病的重要机制.

Apoptosis and proliferation in idiopathic thrombocytopenic purpura

Objective To investigate the changes in lymphocytes apoptosis,bcl xl protein and p65 in patients with idiopathic thrombocytopenic purpura(ITP)and the effect of dexamethasone(DEX)treatment.Methods The blood samples were collected in patients prior and post Dex treatment,in situ cell apoptosis(TUNEL method),bcl xl protein and p65 expression(immunohistochemica method)were detected.Results Prior to Dex treatment,the number of Tunel positive lymphocytes were decreased,PI decreased largely;After Dex treatment,the number of Tunel positive lymphocytes were increased significally( P <0.05).bcl xl protein and p65(NF KB)expression were reduced significally in comparison with prior Dex treatment( P <0.05).Conclusion The result suggests that the abnormal lymphocytes apoptosis and proliferation in patients with ITP might be its important pathogenisis.