急性ITP患者免疫功能变化的动态观察及临床意义

目的:动态观察ITP患者的免疫功能变化,讨论其临床意义。方法:分别于入院时、治疗2周、4周,20周四个时间点测定患者血清中的IL-2受体(sIL-2R)、血小板相关抗体(PAIgG)水平及T淋巴细胞亚群CD4+、CD4+/CD8+。结果:入院时CD4+和CD4+/CD8+显著下降,CD8+、sIL-2R、PAIgG显著升高;治疗起效后sIL-2R和CD8+显著下降,CD4+和CD4+/CD8+显著升高,PAIgG变化趋势不稳定。结论:动态测定sIL-2R水平、CD4+、CD4+/CD8+和CD8+,对判断病情和评估预后有重要意义且sIL-2R水平比T淋巴细胞亚群变化更敏感;而PAIgG的变化对ITP的诊断有意义但与病情轻重没有明显的相关性;应用强的松并不会增加感染可能。

In Series Observation of Immunization Function Variance in the Acute ITP Patients and Its Clinical Meaning

Objective To observe the variance of immunization function in series in the acute ITP patients and discuss its clinical meaning.Methods Assaying the sIL-2R in the patients serums and the PAIgG and the T lymphocyte subgroups CD_4~+、CD_4~+/CD_8~+ at the time of the admissions and 2,4,20 weeks after the effective therapy methods were applied.Results CD_4~+、CD_4~+/CD_8~+ reduced observably and CD_8~+、sIL-2R、PAIgG got remarkable ascrnsion at the time of the admissions;after given the treatment,sIL-2 and CD_8~+ reduced observably and CD_4~+、CD_4~+/CD_8~+ goes up obviously.The trend of the PAIgG is not reliable.Conclusions It does make sense to observe the sIL-2R、CD~+_4、CD_4~+/CD_8~+ and CD_8~+ in judging the ITP cases and forecasting the prognosis.The variance of the PAIgG may help the diagnosis of acute ITP cases while doesn't show remarkable correlation to the severity of the ITP.