特发性血小板减少性紫癜患者外周血淋巴细胞亚群变化

目的探讨特发性血小板减少性紫癜（ITP）患者外周血T淋巴细胞亚群的变化规律及临床意义。方法用ELISA法检测42例ITP患者和30例对照者血小板相关免疫球蛋白水平，用流式细胞仪直接免疫法检测外周血T淋巴细胞亚群CD3＋、CD4＋、CD8＋、CD4＋／CD8＋，并评价其与血小板抗体水平的相关性。结果ITP患者PAIgG、PAIgA、PAIgM水平均显著高于对照者（P〈0．01）；与对照者相比，ITP患者外周血CD3＋显著降低（P〈0．01），CD4＋减低（P〉0．05），CD8＋明显升高（P〈0．05），而CD4＋／CD8＋比值显著降低（P〈0．01），同时CD4＋／CD8＋比值的降低与血小板表面抗体IgG、IgA、IgM增高有显著的相关性。结论ITP患者存在T淋巴细胞亚群功能和比例失常，存在T淋巴细胞亚群分布漂移，T淋巴细胞亚群检测对ITP的诊断有指导意义。

The changes of peripheral blood lymphocyte subsets in patients with idiopathic thrombocytopenic purpura

Objective To investigate the changes and clinical significance of peripheral blood lymphocyte subsets in patients with idiopathic thrombocytopenic purpura (ITP). Methods PAIgG, PAIgM, PAIgA in platelets and CD3+ , CD4+ , CD8+, CD4+/CD8+ antigen expression in peripheral blood of 42 patients with ITP and 30 normal controls were detected by ELISA and FACS, respectively. And the correlation between the two indicators was evaluated.Results The levels of PAIgG, PAIgA, PAIgM in platelets of patients with ITP were significantly higher than the normal controls( P ＜ 0.01 ). Compared with the normal controls, the percentage of CD3+ and ratio of CD4+/CD8+ cell were significantly lower in ITP patients than that in normal controls, and the percentage of CD8+ cell in ITP patients was much higher than that in normal controls. The decreasing ratio of CD4+/CD8+ cell was significantly correlated with the levels of PAIgG,PAIgM, PAIgA. Conclusion Tlymphocyte subsets showed abnormal function and ratio of lymphocyte subsets in ITP patients, and played an important role in pathological mechanism and diagnosis of ITP.