儿童ITP外周血相关实验室检查及临床意义

目的探讨儿童特发性血小板减少性紫癜患者淋巴细胞数量和血小板相关抗体动态变化及临床意义。方法选取2010年1月~2012年12月就诊并进行治疗的患有特发性血小板减少性紫癜儿童108例作为研究对象,其中急、慢性患者分别为48、60例,选取同期体检的健康儿童108例作为对照组。分别于治疗前后检测患者CD3、CD4、CD8、CD19和CD3-/HLA-DR+及PA-IgA、PA-IgG、PA-IgM水平。结果急、慢性组CD4水平均低于对照组(P0.01),急性组CD4水平高于慢性组(P0.01);急、慢性组CD8、CD19、CD3-/HLA-DR+水平均高于对照组(P0.01),急性组CD19水平高于慢性组(P0.05)。治疗后1周,患者CD8水平与治疗前比较差异有统计学意义(P0.05);治疗后4周,患者CD4、CD8、CD19和CD3-/HLA-DR+水平与治疗前相比,差异均有统计学意义;治疗后8周,患者CD4、CD8、CD19和CD3-/HLA-DR+水平均接近对照组正常水平(P0.05)。患者治疗前PA-IgA、PA-IgG、PA-IgM平均水平均高于对照组(P0.05);治疗后1周,PA-IgG、PA-IgM水平低于治疗前(P0.05),PA-IgG、PA-IgM平均水平与对照组间的差异均有统计学意义(P0.05)。结论儿童特发性血小板减少性紫癜主要表现在T淋巴细胞亚群、B淋巴细胞和PA-Ig的异常上。联合检测淋巴细胞亚群和PA-Ig对儿童特发性血小板减少性紫癜的诊断和疗效判定具有较高的实用价值。

Laboratory tests of peripheral blood of children with idiopathic thrombocytopenic purpura and its clinical significance

Objective To explore quantity change and its clinical significance of immunological cells and PA-Ig among children with idiopathic thrombocytopenic purpura（ITP）. Methods The 108 children with idiopathic thrombocytopenic purpura during 2010-2012 in the hospital were chosen including 48 chronic patients and 60 acute cases,respectively. Another 108 healthy children were taken as control group. The levels of CD3, CD4, CD8, CD19, CD3-/HLA-DR＋, PA-IgA, PA-IgG and PA-IgM were detected. Results The CD4 levels in acute and chronic groups were both lower than that of control group （P〈0.01）.CD4 levels in cases of acute group was higher than that of chronic group（P〈0.01）,CD8, CD19, CD3-/HLA-DR＋ levels were all higher than those of control group（P〈0.01）, and CD19 levels in cases of acute group was higher than that of chronic group（P〈0.05）. 1 week after treatment, CD8 levels was lower than that before treatment（P〈0.05）. 4 weeks after treatment, the differences of CD4, CDS, CD19, CD3-/HLA-DR＋ levels were all significantly statistic compared with before treatment. The levels of PA-IgG and PA-IgM were both lower compared with before treatment, while higher than control group（P〈0.05）. Conclusion The abnormalities of B-lymphocyte, T- lymphocyte and PA-Ig were main clinical situation among children with ITP. The combination detection of B-lymphocyte, T- lymphocyte and PA-Ig are valuable for diagnosis and assessment of treatment.of ITP.