摘要
目的研究成人慢性免疫性血小板减少症(Immune Thrombocytopenia,ITP)患者免疫细胞、免疫因子表达水平以及二者之间的相关性。方法选取2013年11月~2017年3月期间我院血液科收治的240例ITP患者,根据ITP国际工作组提出的诊断标准分为重度ITP患者(重度ITP组)和非重度ITP患者(非重度ITP组),每组各120例。另外选择同期120例健康体检人员,作为健康组。分别检测上述三组Th1细胞、Th17细胞、调节性T细胞(Regulatory cells,Tregs)、Th17/Treg、自然杀伤细胞(natural killer cell,NK)、树突状细胞(Dendritic cells,DC)等细胞比例和白介素-2(Interleukin-2,IL-2)、白介素-6(Interleukin-6,IL-6)、肿瘤坏死因子(Tumor Necrosis Factor,TNF-α)、γ-干扰素(Interferon-γ,IFN-γ)、免疫球蛋白G(Immunoglobulin G,IgG)等免疫因子表达水平,分别分析与ITP病情之间以及二者之间的相关性。结果免疫细胞Th17、Treg、Th17/Treg和DC比例与患者病情呈显著相关性,而Th1、NK细胞比例与患者病情无显著相关性;免疫因子IL-2、IL-6、TNF-α、IFN-γ与患者病情呈显著相关性,而Ig G与患者病情无显著相关性。免疫细胞与免疫因子在ITP中的相关性分析显示,Th1细胞比例与IL-2、IL-6、TNF-α呈显著正相关;Th17细胞比例与IL-2、IL-6、IFN-γ呈显著正相关;Treg细胞比例与IL-2、IL-6、TNF-α、IFN-γ呈显著负相关;Th17/Treg细胞比例与IL-2、IL-6、TNF-α、IFN-γ、IgG呈显著正相关;NK细胞比例与IL-6、TNF-α、IFN-γ呈显著正相关;DC比例与IL-2、IL-6、TNF-α呈显著正相关。结论细胞免疫失衡引起机体免疫因子水平异常,是导致ITP发生发展的促进因素。
Objective To study the expression of immune cells and immune factors in adult patients with chronic immune thrombocytopenia(ITP) and the correlation between them. Methods A total of 240 ITP patients admitted to our Department of Hematology from November 2013 to March 2017 were enrolled. According to the diagnostic criteria proposed by the ITP International Working Group, they were divided into severe ITP patients(severe ITP group) and nonsevere ITP patients(non-severe ITP group), with 120 cases in each group. In addition, 120 health inspectors were selected as the health group. The ratio of cells of Th1 cells, Th17 cells, Regulatory cells(Tregs), Th17/Treg, natural killer cells(NK), and dendritic cells(DC), and interleukin-2(IL-2), interleukin-6(IL-6), Tumor Necrosis Factor(TNF-α),γ-interferon(Interferon-γ, IFN-γ), immunoglobulin G(IgG) and other immune factor expression levels in the above three groups were detected. And their correlation with ITP conditions and their correlation with each other were analyzed respectively. Results The ratio of Th17, Treg, Th17/Treg and DC in immune cells was significantly correlated with the patient’s condition, while the ratio of Th1 and NK cells was not significantly correlated with the patient’s condition. The immune factors IL-2, IL-6, TNF-α, IFN-γ was significantly associated with the patient’s condition, and IgG was not significantly associated with the patient’s condition. Correlation analysis between immune cells and immune factors in ITP showed that the ratio of Th1 cells was positively correlated with IL-2, IL-6 and TNF-α;the ratio of Th17 cells was significantly positively correlated with IL-2, IL-6 and IFN-γ;the proportion of Treg cells was significantly negatively correlated with IL-2, IL-6, TNF-α and IFN-γ;the ratio of Th17/Treg cells was significantly positively correlated with IL-2, IL-6, TNF-α, IFN-γ and IgG. NK cell ratio was significantly positively correlated with IL-6, TNF-α and IFN-γ;DC ratio was significantly positively correlated wit
作者
曹丹
寿黎红
费菊萍
方遒
董晓辉
徐宝连
张燕
CAO Dan;SHOU Lihong;FEI Juping;FANG Qiu;DONG Xiaohui;XU Baolian;ZHANG Yan(Department of Hematology, Huzhou Central Hospital in Zhejiang Province, Huzhou 313000, China)
出处
《中国现代医生》
2019年第18期33-37,共5页
China Modern Doctor
基金
浙江省医药卫生一般研究计划(2015KYA210)
