摘要
目的探讨抗血小板抗体与ITP患儿IVIG治疗疗效及Treg/Th17免疫细胞比例失衡之间的关系。方法分析抗血小板抗体阳性与阴性各60例原发性ITP患儿接受IVIG治疗前后血小板计数、Treg/Th17比例的变化及相关性。结果1)与对照组相比,病例组ITP患儿IVIG治疗疗效较好(治疗有效:50 vs 32)(P<0.01)。2)IVIG治疗后,2组患儿血小板计数(×10^(9)/L)(病例组:4.5±2.9 vs 327.4±69.5,对照组:4.1±3.2 vs 304.7±75.9)、Treg细胞水平(%)(病例组:2.15±1.08 vs 5.09±1.37,对照组:2.41±0.92 vs 4.98±1.10),Treg/Th17比例显著升高(病例组:1.10±0.19 vs 4.75±1.11,对照组:1.27±0.21 vs 4.69±0.81),Th17细胞水平(%)显著降低(病例组:2.07±1.31 vs 1.37±0.92,对照组:2.13±1.18 vs 1.48±1.01);与对照组相比,病例组Treg、Th17和Treg/Th17比例在治疗前后均无显著变化(P>0.05),但血小板计数增加更明显(P<0.05)。3)IVIG治疗后对照组阳性3例,而病例组阴性12例,IVIG治疗对ITP患儿抗血小板抗体的阳性率可能没有影响(P>0.05)。4)IVIG治疗后血小板计数变化与Treg水平呈显著正相关(病例组r=0.49,对照组r=0.441),与Th17细胞水平呈显著负相关(病例组r=-0.390,对照组r=-0.364)。结论抗血小板抗体可以作为ITP患儿IVIG治疗疗效的1种预测指标,但其与Treg/Th17比例变化无关。
Objective To investigate the relationship between anti-platelet antibodies,therapeutic effect of intravenous immunoglobulin(IVIG)and Treg/Th17 cells imbalance in children with immune thrombocytopenia(ITP).Methods The changes and correlation of platelet count and Treg/Th17 ratio before and after IVIG treatment in 60 newly diagnosed ITP children with anti-platelet antibodies and 60 children with primary ITP without anti-platelet antibodies were analyzed.Results 1)Compared with the control group,the efficacy of IVIG treatment was better in children with ITP in the case group(CR+R cases:50 vs 32)(P<0.01).2)After IVIG treatment,platelet count(×10^(9)/L)(case:4.5±2.9 vs 327.4±69.5,control:4.1±3.2 vs 304.7±75.9),Treg cell level(%)(case:2.15±1.08 vs 5.09±1.37,control:2.41±0.92 vs 4.98±1.10),Treg/Th17 ratio(case:1.10±0.19 vs 7.75±1.11,control:1.27±0.21 vs 4.69±0.81)significantly increased while Th17 cell level(%)significantly decreased in the 2 groups of children(case:2.07±1.31 vs 1.37±0.92,control:2.13±1.18 vs 1.48±1.01);compared with the control group,there was no significant change in Treg,Th17 and Treg/Th17 ratio before and after treatment in the case group(P>0.05),but platelet count increased more significantly(P<0.05).3)There were 3 positive cases in the control group and 12 negative cases in the case group after IVIG treatment,and IVIG treatment probably had no effect on the positive rate of anti-platelet antibodies in children with ITP(P>0.05).4)The change in platelet count after IVIG treatment was significantly positively correlated with Treg levels(r=0.49 in the case group and r=0.441 in the control group)and negatively correlated with Th17 cell levels(r=-0.390 in the case group and r=-0.364 in the control group).Conclusion Anti-platelet antibodies can be used as a predictor of the efficacy of IVIG therapy in children with ITP,but they are not associated with changes in the Treg/Th17 ratio.
作者
许军秀
肖玉龙
张根豪
XU Junxiu;XIAO Yulong;ZHANG Genhao(Department of Clinical Laboratory,the fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Blood Transfusion,the first Affiliated Hospital of Zhengzhou University)
出处
《中国输血杂志》
CAS
2021年第9期1003-1005,共3页
Chinese Journal of Blood Transfusion
