重组人血小板生成素联合大剂量地塞米松对原发性ITP病人Treg细胞及Th1、Th2细胞的影响

目的观察重组人血小板生成素(rhTPO)联合大剂量地塞米松方案对原发性免疫性血小板减少症(ITP)病人调节性T细胞(Treg)及辅助性T细胞(Th)1、Th2表达水平的影响。方法选择ITP病人82例，按照随机数字表法分为对照组40例和观察组42例。对照组给予大剂量地塞米松治疗，观察组在对照组治疗基础上加用rhTPO治疗。比较2组病人疗效，并采用流式细胞仪检测2组治疗前后Treg细胞和Th1、Th2细胞表达水平及Th1/Th2比例。结果观察组病人疗效优于对照组(P < 0.05)。治疗前，2组病人Treg细胞和Th1、Th2细胞表达水平及Th1/Th2比例差异均无统计学意义(P>0.05)；治疗后，2组病人Treg细胞及Th2细胞均较治疗前明显上调(P < 0.01)，Th1细胞和Th1/Th2比例均较治疗前明显下降(P < 0.01)，且观察组Treg细胞及Th2细胞表达水平均明显高于对照组(P < 0.01)，Th1细胞和Th1/Th2均明显低于对照组(P < 0.01)。结论rhTPO联合大剂量地塞米松治疗原发性ITP能通过增加病人Treg细胞数量、纠正Th1/Th2细胞平衡，提高临床疗效。

Effect of the recombinant human thrombopoietin combined with high dose dexamethasone on the Treg cells,Th1 cells and Th2 cells in primary immune thrombocytopenia patients

ObjectiveTo observe the effects of recombinant human thrombopoietin(rhTPO) combined with high dose dexamethasone on the expression levels of CD4+CD25+Foxp3+regulatory T cells(Treg), T-helper 1(Th1) cells and T-helper 2(Th2) cells in primary immune thrombocytopenia(ITP) patients.MethodsEighty-two patients with ITP were divided into the control group(40 cases) and observation group(42 cases) according to the random number table method.The control group was treated with high-dose dexamethasone, and the observation group was treated with rhTPO on the basis of the control group.The therapeutic effects were compared between two groups.The expression levels of Treg cells, Th1 cells and Th2 cells, and the ratio of Th1/Th2 in two groups before and after treatment were detected using flow cytometry.ResultsThe total effective rate in observation group was significantly better than that in control group(P < 0.05).Before treatment, there was no statistical significance in the expression levels of Treg cells, Th1 cells and Th2 cells, and the ratio of Th1/Th2 between two groups(P>0.05).After treatment, the levels of Treg cells and Th2 cells were significantly up-regulated (P < 0.01), and the ratio of Th1 cells and Th1/Th2 decreased significantly compared with before treatment(P < 0.01).After treatment, the expression levels of Treg cells and Th2 cells in observation group were significantly higher than those in control group(P < 0.01), and the Th1 cells and Th1/Th2 ratio in observation group were significantly lower than those in control group(P < 0.01).ConclusionsThe rhTPO combined with high dose dexamethasone in the treatment of ITP can improve the clinical therapeutic effects through increasing the number of Treg cells and correcting the balance of Th1/Th2 cells.