CD4^＋CD25^＋调节性T细胞在特发性血小板减少性紫癜患者中的变化及意义

目的:通过检测特发性血小板减少性紫癜(ITP)患者治疗前后外周血CD4 CD25 调节性T细胞(regulatory T cell,Treg)的比例及变化规律,探讨Treg细胞在ITP发病中的可能作用。方法:采集30例急、慢性ITP患者治疗前、后和20例正常对照者的外周血标本,流式细胞仪检测Treg细胞的比例及变化,并评价其与血小板计数的相关性。结果:30例ITP患者治疗前Treg细胞的比例为(1.59±0.86)%,明显低于正常对照组(3.87±1.73)%(P<0.01),治疗后其比例显著升高,为(2.51±1.17)%,明显高于治疗前(P<0.01),但仍低于正常对照组(P<0.01);Treg细胞在治疗显效和良效组显著高于进步和无效组(P<0.01),进步组与无效组比较差异无统计学意义(P>0.05);此外治疗前后Treg细胞比例与血小板计数呈显著正相关(P<0.05)。结论:ITP患者外周血Treg细胞比例降低,但随免疫抑制治疗的疗效逐渐升高,提示CD4 CD25 调节性T细胞可能参与了ITP的发病机制。

Change and significance of CD4+CD25+ regulatory T cells in idiopathic thrombocytopenic purpura

Objective:To explore the role of CD4 CD25 regulatory T cells in pathophysiology of idiopathic thrombocytopenic purpura(ITP) by analyzed the rate in ITP patients.Method:Peripheral blood mononuclear cells (PBMNCs) from 30 cases of ITP patients and 20 cases of health controls were collected and the population of CD4 CD25 regulatory T cells was detected by flow cytometry. The correlation between CD4 CD25 regulatory T cells and platelet counts was analyzed.Result:The proportion of CD4 CD25 regulatory T cells in ITP patients before therapy was decreased remarkably than that of health control group (P<0.01),the rate significantly higher after therapy than that of patients before therapy (P<0.01),but less than that of health control group (P<0.01). The proportion of CD4 CD25 regulatory T cells in the effective therapy group was higher than that of in the refractory group (P<0.01). No significant difference between the progressing therapy group and no effective therapy group (P>0.05). There was a significant correlation between CD4 CD25 regulatory T cells and platelet counts (P<0.05).Conclusion:The low percentage of CD4 CD25 regulatory T cells in ITP patients may be involved in pathophysiology of ITP.