外周血淋巴细胞亚群变化在特发性血小板减少性紫癜中的意义

目的观察特发性血小板减少性紫癜(ITP)患者治疗前后外周血淋巴细胞亚群水平变化,评价其在ITP发病机制研究和治疗中的价值。方法利用流式细胞术检测ITP患者外周血淋巴细胞亚群(CD3 、CD3 CD4 、CD3 CD8 、CD19 、CD19 CD5 )水平。结果ITP组治疗前CD3 T淋巴细胞、CD3 CD4 T淋巴细胞百分率以及CD3 CD4 /CD3 CD8 比例减低,CD3 CD8 T淋巴细胞、CD19 B淋巴细胞、CD19 CD5 B淋巴细胞百分率均升高,与对照组相比较,差异有显著性(P<0.05)。ITP组治疗后,27例有效,9例无效。治疗有效组治疗后CD3 T淋巴细胞、CD3 CD4 T淋巴细胞百分率以及CD3 CD4 /CD3 CD8 比例升高,CD3 CD8 T淋巴细胞、CD19 B淋巴细胞、CD19 CD5 B淋巴细胞百分率均减低,与治疗前相比,差异有显著性(P<0.05),与健康对照组相比,差异无显著性(P>0.05);治疗无效组治疗后淋巴细胞亚群与治疗前相比,差异无显著性(P>0.05)。结论ITP患者外周血淋巴细胞亚群水平存在异常,可能与ITP患者体内细胞免疫和体液免疫紊乱有关,并在其中发挥重要的作用,治疗前后外周血淋巴细胞亚群水平的变化对于研究ITP发病机制以及观察ITP临床病情转归均起着一定的作用。

Significance of the changes of lymphocyte subpopulations in idiopathic thrombocytopenic purpura

Objective To study the changes of lymphocyte subpopulations in patients with idiopathic thrombocytopenic purpura(ITP).Methods The ratios of lymphocyte subpopulations(CD3 ,CD3 CD4 ,CD3 CD8 ,CD19 ,CD19 CD5 ) in peripheral blood were analyzed by flowcytometry(FCM).Results Compared with the ratios of lymphocyte subpopulations in healthy controls,CD3 ,CD3 CD4 subsets and CD3 CD4 /CD3 CD8 in ITP patients significantly decreased and CD3 CD8 ,CD19 and CD19 CD5 subsets obviously increased(P<0.05). After treatments, the effective cases in ITP patients were twenty-seven and the refractory cases were nine. CD3 ,CD3 CD4 subsets and CD3 CD4 /CD3 CD8 in effective cases increased but CD3 CD8 ,CD19 ,CD19 CD5 subsets decreased compared with that of the ITP patients before treatments(P<0.05). At the same time, the ratios of lymphocyte subpopulations after treatments in refractory cases did not obviously changed(P>0.05).Conclusions These results indicate that the changes of lymphocyte subpopulations in idiopathic thrombocytopenic purpura may play a significant role in the pathogenesis and therapeutics of patients with ITP.