特发性血小板减少性紫癜外周血Th1／Th2平衡偏移的研究

目的拟建立一种准确的、客观的检测T淋巴细胞亚群的方法，探讨在特发性血小板减少性紫癜（ITP）中T淋巴细胞亚群Th1／Th2平衡状态的变化及其意义。方法选择2007年3月至2008年2月在延安大学附属医院血液免疫科住院的30例特发性血小板减少性紫癜（ITP组）和同期20例健康体检者（对照组）作为研究对象，收集其外周抗凝血，以PE标记的抗CD195单抗和CD30单抗与FITC标记的抗CD4单抗作双色流式细胞术，用淋巴细胞设门，分别以CD4^＋ CD195^＋和CD4^＋CD30^＋细胞代表Th1、Th2细胞，分析ITP患者及健康人外周血T细胞各亚群百分率及Th1／Th2比例的变化。结果ITP组治疗前Th1、Th2细胞百分比均低于对照组，而Th1／Th2比值高于对照组，差异具有显著性（P〈0．05）；经大剂量人免疫球蛋白和地塞米松冲击治疗后，血小板数上升，Th1／Th2比值降低，与治疗前相比差异有显著性（P〈0．05）。结论在ITP患者中外周血T淋巴细胞表面标志表达异常，T细胞亚群比例失调，即ITP患者体内Th1／Th2比值升高，提示特发性血小板减少性紫癜是一种Tb1优势的疾病。

Modulation of Th1/Th2 balance in patients with idiopathic thrombocytopenic purpura

Obective To use flow cytometry to detect T cell subgroups and to investigate change in balance of Th1/Th2 subgroups in idiopathic thrombocytopenic purpura （ITP） and its significance. Methods Thirty cases of ITP and 20 normal controls were selected. Peripheral blood samples were collected and flow cytometry was conducted with PE labeled anti - CD195 MAb, anti - CD30 MAb, and FITC labeled anti - CD4 MAb. Results Th1 and Th2 percentage in patients with ITP was significantly lower than that in control group （ P 〈 0.05 ）. After treatment with human immunoglobulin and dexamethasone,platelet number was increased （ P 〈 0. 001 ） and Th1/Th2 ratio was decreased significantly （ P 〈 0.05 ）. Conclusion PeripherY＂ blood T cell markers were expressed abnormally in patients with ITP. Deregnlated T cell subgroup proportion （ elevated Th1/Th2 ratio）, suggests ITP is a Th1 dominated disease.