特发性血小板减少性紫癜患者外周血淋巴细胞亚群和血小板抗体的研究

目的　探讨淋巴细胞亚群和血小板相关抗体的变化 ,在特发性血小板减少性紫癜 (ITP)免疫发病机制中的作用。方法　用流式细胞仪直接免疫法检测 172例ITP患者发病期外周血淋巴细胞亚群CD3( +) 、CD4 ( +) CD3( +) CD8( +) 、CD4 ( +) /CD8( +) 、CD 19( +) 、CD3( +) /CD 16 ( +) CD 5 6 ( +) 。ELISA法检测血小板表面血小板相关抗体IgG、IgA、IgM。结果　发病期ITP患者与正常对照组比较CD3( +) 显著降低 (P <0 0 1) ,CD8( +) 增高 (P <0 0 5 ) ,CD4 ( +) /CD8( +) 比例显著下降 (P <0 0 1) ,CD 19( +) 增高极为显著 (P <0 0 0 1) ,血小板表面PAIgG、PAIgA、PAIgM显著高于对照组 ,同时CD 19( +) 的升高和CD4 ( +) /CD8( +) 的下降与PAIgG、PAIgA、PAIgM增高有显著的相关性。结论　淋巴细胞亚群功能和比例的失常 ,T细胞免疫调节机制的紊乱在ITP的发病机制中起了非常重要的作用

The Changes of Lymphocyte Subsets and PAIg in Patients with Idiopathic thrombocyte Prpuura

Objective To investigate the changes of lymphocyte subsets, PAIg and effects on pathological mechanism of TIP. Methods CD3 (+) CD4 (+) , CD3 (+) CD8 (+) , CD4 (+) /CD8 (+) , CD 19 (+) , CD3 (+) /CD 16 (+) , CD 56 antigen expression on the lymphocyte in the peripheral blood and PAIgA, PAIga, PAIgM in platelets of 172 patients with ITP and 42 normal controls were assayed by ELISA and FACS, respectively. Results The percentage of CD3 (+) cell and ratio of CD4 (+) /CD8 (+) cell were significantly lower (P<0.01) on ITP patients than that in normal controls, and the percentage of CD8, CD 19 (+) cell in ITP patients much higher than that in normal controls (P<0.05,P<0.01). The levels of PAIgG, PAIgA, PAIgM in platelets were significantly higher in ITP patients than that in normal controls (P<0.001). The increasing percentage of CD 19 (+) cell and decreasing ratio of CD4 (+) CD8 (+) cell were significantly correlated with the levels of PAIgG, PAIgA, PAIgM in patients (P<0.001). Conclusion The abnormal function and ratio of lymphocyte subsets, as well as the immunologic mechanism disorder of lymphocyte subsets, as well as the immunologic mechanism disorder of lymphocytes play an important role in pathological mechanism of ITP.