摘要
目的探究共刺激信号分子(CD80、CD86)表达水平与免疫性血小板减少症(ITP)患者免疫功能的相关性。方法纳入初诊ITP患者60例(初诊组),另取完全缓解患者45例(缓解组),健康志愿者30例(对照组),采用流式细胞技术检测各组外周血CD19^+CD80^+、CD19^+CD86^+及CD19^+B细胞内抗体IgG和IgM的表达情况。对初诊组进行治疗后根据治疗效果分为治疗后难治组(18例)和治疗后缓解组(42例),对比分析CD80、CD86表达与患者免疫功能及疗效的相关性。结果初诊组CD19^+CD80^+、CD19^+CD86^+、IgG、IgM、Th1、Th1/Th2表达水平高于缓解组和对照组,差异有统计学意义(P<0.05);治疗后缓解组CD19^+CD80^+、CD19^+CD86^+、IgG、IgM、Th1、Th1/Th2表达水平显著低于治疗前,差异有统计学意义(P<0.05);外周血CD19^+CD80^+、CD19^+CD86^+、IgG、IgM、Th1、Th1/Th2表达水平与ITP治疗效果密切相关(P<0.05)。CD19^+CD80^+与CD19^+B细胞内抗体IgG、IgM的表达存在线性正相关关系(r=0.227、0.582,P<0.05),CD19^+CD86^+与CD19^+B细胞内抗体IgG、IgM的表达存在线性正相关关系(r=0.453、0.276,P<0.05)。结论 ITP患者外周血CD80、CD86通过影响CD19^+B细胞活化来介导免疫紊乱,参与ITP的发生、发展,其表达水平与血小板抗体水平、糖皮质激素治疗效果和预后密切相关。
Objective To explore the correlation between the expression of costimulatory signal molecules(CD80,CD86)and immune function in patients with immune thrombocytopenia(ITP). Methods 60 cases of patients with ITP and who newly diagnosed and 45 cases of patients with complete remission were included,and another 30 cases of healthy volunteers were selected as control group. The expressions of IgG and IgM in CD19^+CD80^+,CD19^+CD86^+and CD19^+B cells were detected by the flow cytometry methods. After treatment,the initial group was divided into the refractory group(18 cases)and the remission group(42 cases). The correlation between the expression of CD80 and CD86 and immune function and clinical effect were compared and analyzed. Results The expression levels of CD19^+CD80^+,CD19^+CD86^+,IgG,IgM,Th1,Th1/Th2 in the newly diagnosed group were significantly higher than those in the remission group and the control group(P<0.05). The expression levels of CD19^+CD80^+,CD19^+CD86^+,IgG,IgM,Th1 and Th1/Th2 in remission group were significantly lower than those before treatment(P<0.05). The expression levels of CD19^+CD80^+,CD19^+CD86^+,IgG,IgM,Th1 and Th1/Th2 in peripheral blood were closely related to the treatment effect of ITP(P<0.05). There was linear positive correlation between CD19^+CD80^+and the expression of IgG and IgM in CD19^+B cells(r=0.227,0.582,P<0.05). There was linear positive correlation between CD19^+CD86^+and the expression of IgG and IgM in CD19^+B cells(r=0.453,0.276,P<0.05). Conclusion The CD80 and CD86 in peripheral blood of ITP patients might mediate immune disorders by affecting the activation of CD19^+B cells,and the participate in the occurrence and development of ITP;its level was closely related to platelet antibody level,glucocorticoid treatment effect and prognosis.
作者
张雷
何流
杨敏
龙佩
ZHANG Lei;HE Liu;YANG Min;LONG Pei(Laboratory Department of Guang′an People′s Hospital,Guang′an,Sichuan 638000,China)
出处
《热带医学杂志》
CAS
2020年第2期241-244,260,共5页
Journal of Tropical Medicine
