Th17细胞及其分泌的IL-17在特发性血小板减少性紫癜患者中的变化及临床意义

目的探讨辅助性T17细胞（Th17）及其分泌的细胞因子白细胞介素（IL）-17在特发性血小板减少性紫癜（ITP）患者中的变化及临床意义。方法选择2010年11月至2012年1月于大连医科大学附属第-医院就诊的门诊和住院ITP患者38例为研究对象，纳入研究组；随机选取同期于本院体检的健康成年人30例纳入对照组。两组-般情况，如年龄、性别等比较，差异无统计学意义（P〉0．05）。应用流式细胞术（FCM）检测研究组治疗前、糖皮质激素治疗后及对照组外周血中Th17细胞的比率，同时用酶联免疫吸附试验（ELISA）法检测各组血清中IL-17的水平（本研究遵循的程序符合大连医科大学附属第-医院人体试验委员会所制定的伦理学标准，得到该伦理会批准，分组征得受试对象本人的知情同意，并与之签订临床研究知情同意书）。结果研究组治疗前外周血中Th17细胞比率和血清中IL-17的水平分别为（1．384-0．42）％和（25．52±6．83）ng／L，与对照组的（0．71±0．29）％和（8．23±3．15）ng／L比较，差异有统计学意义（P〈0．05），研究组患者外周血中Th17细胞比率和血清中IL-17的水平较对照组显著增高。研究组经糖皮质激素治疗后，外周血中Th17细胞比率和血清中IL-17的水平分别为（1．05±0．31）％和（17．46±5．14）ng／L，较治疗前显著降低（P〈0．05）。结论ITP患者外周血中Th17细胞的比率及其IL-17的水平均升高，经糖皮质激素治疗后可下调Th17细胞的比率和IL-17的水平，有效地缓解ITP。

Changes and Clinical Significances of Th17 Cells and Their Secretive IL-17 in Patients With Idiopathic Thrombocytopenic Purpura

Objective To investigate the changes and clinical significances of T cells helper （Th） 17 cells and interleukin （IL）-17 of idiopathic thrombocytopenic purpura （ITP） patients before and after glucocorticoid treatment. Methods From November 2010 to January 2012, a total of 38 cases of ITP patients who received treatments in First Affiliated Hospital of Dalian Medical University were included into this study, as study group. A total of 30 healthy adults who received medical examination at the same period were included into control group. There was no significant difference between two groups among age, gender and other general information （P〉0.05）. Flow cytometry （FCM） was used to detect the rate of Th17 cells in ITP patients. The levels of serum IL-17 in ITP patients were measured by enzyme-linked immunosorbent assays （ELISA） （The study protocol was approved by the Ethical Review Board of First Affiliated Hospital of Dalian Medical University）. Results Before treatment, the rate of Thl7 cells and the levels of serum IL-17 in study group were significantly higher than that in control group （1.38±0.42）%, （25. 52±6.83） ng/L vs. （0.71±0.29）%, （8.23±3.15） ng/L] （P〈0.05）. The percentage of Th17 cells （1. 05±0.31）%] was significantly decreased after treatment （P〈0.05） and the same tendency was also found in the levels of serum IL-17（17. 46±5.14） ng/L]（P〈0.05）. Conclusions The rate of Thl7 cells and the levels of serum IL-17 significantly elevate in ITP patients. Glucocorticoid might play a role in ITP treatment by down regulating Thl7 cells number and concentrations of IL-17.