摘要
目的检测原发性免疫性血小板减少症（ITP）患者CD4^＋CD25^＋调节性T细胞的表达，分析其与临床预后的相关性。方法选取2014年1月至2015年10月原发免疫性血小板减少症患者63例，根据血小板减少程度分为轻型组、中型组和重型组，另选择同期健康体检者50例，应用流式细胞仪检测三组患者和健康体检者外周血CD4^＋CD25^＋调节性T细胞的表达水平；分析CD4^＋CD25^＋调节性T细胞与疾病严重程度及临床预后的相关性。结果治疗前，轻型组CD4^＋CD25^＋调节性T细胞表达水平（4．12±1．26）％，中型组（2．42±0．65）％，重型组（1．31±0．54）％，与对照组（6．58±1．55）％比较，均明显降低（P〈0．001）；不同严重程度组间比较显示，重型组CD4^＋CD25^＋调节性T细胞表达水平低于中型组（P〈0．01），中型组低于轻型组（P〈0．001）。治疗后，完全反应组CD4^＋CD25^＋调节性T细胞水平（5．35±0．88）％明显高于有效组（4．16±1．18）％及无效组（1．73±O．53）％，差异均有统计学意义（P〈0．01），而有效组明显高于无效纽（P〈0．01），但三组水平仍低于对照组（P〈0．01）。相关性分析显示，CD4^＋CD25^＋调节性T细胞水平与ITP患者病情及临床预后均明显相关（r=0．903，P〈0．001；r=0．825，P〈0．001）。结论检测CD4^＋CD25^＋调节性T细胞的表达有助于判断原发免疫性血小板减少症患者病情严重程度，评估临床预后。
Objective The expression levels of CD4^＋CD25^＋ regulatory T cells in primary immune thromboeytopenia （ ITP ） , and to explore the association with clinical prognosis. Methods 63 patients diagnosed with ITP from Jan 2011 to Oct 2015 were enrolled into the study. They were divided into mild, moderate and severe group according to the platelet count. 50 healthy controls were selected as control group. The expressions of CD4^＋CD25^＋ regulatory T cells in peripheral blood of ITP patients and healthy controls were accounted by flow cytometry （ FCM ） before treatment. The correlation was analyzed between CD4^±CD25^± regulatory T cells and clinical prognosis. Results The expressions of CD4^＋CD25^＋ regulatory T cells in mild, moderate and severe group [ （ 4.12 ± 1.26 ） %, （ 2.42 ± 0.65 ） %, （ 1.31 ± 0.54 ） %, respectively ] were all significantly lower than those in control group [ （ 6.58 ± 1.55 ） %, all P〈0.001 ] before treatment. The expressions of CD4^＋CD25^＋ regulatory T cells in mild were significantly lower than those in moderate group （ P〈0.01 ） . So was the moderate and severe group （ P〈0.001 ） . After treatment, the expressions of CD4^＋CD25^＋ regulatory T cells were significantly higher in complete-reaction （CR） group than reaction （R） group and non-reaction （NR） group [ （5.35±0.88） %, （4.16±1.18） %, （ 1.73 ± 0.53 ） %, respectively; all P〈0.01 ] . But the expressions of CD4^＋CD25^＋ regulatory T cells in 3 groups were still all significantly lower than those in control group （ P〈0.01 ） . The expressions of CD4^＋CD25^＋ regulatory T cells were positively correlated with the severity of illness and clinical prognosis （ r=0.903, P〈0.001 ; r=0.825, P〈0.001 ） . Conclusion The expressions of CD4^＋CD25^＋ regulatory T cells decrease in ITR Detection of CD4^＋CD25^＋ regulatory T cells can help diagnosis the severity of illness, and predict clinical prognosis.
出处
《浙江临床医学》
2017年第3期446-448,共3页
Zhejiang Clinical Medical Journal
