摘要
目的:分析外周血Th17/Treg失衡与儿童免疫性血小板减少症严重程度及预后的关系。方法:选取徐州市儿童医院2017年1月-2021年9月接诊的65例免疫性血小板减少症患儿作为研究对象。根据病情严重程度,分为重型组(30例,血小板计数<10×10^(9)/L)和非重型组(35例,血小板计数≥10×10^(9)/L)。所有患儿均予以丙种球蛋白和糖皮质激素治疗,检测外周血指标(Th17细胞和Treg细胞比例及外周血Th17/Treg比值)及炎症因子(血清IL-4、IL-6、IL-10、IL-17)水平。比较重型组和非重型组外周血指标、炎症因子。使用Pearson相关性分析外周血Th17/Treg比值与血小板计数、起效时间的关系。并根据病情是否缓解,对患者进行分组。比较治疗前1 d缓解组与未缓解组外周血指标。结果:重型组外周血Th17细胞比例、Th17/Treg比值均高于非重型组,Treg细胞比例低于非重型组(P<0.05)。重型组血清IL-4、IL-10水平均低于非重型组,IL-6、IL-17水平均高于非重型组(P<0.05)。经Pearson相关性分析,外周血Th17/Treg比值与血小板计数呈负相关(r=-0.784,P=0.000),与起效时间呈正相关(r=0.691,P=0.000)。所有患儿均完成治疗,在治疗3个月内缓解52例,纳入缓解组,未缓解13例,纳入未缓解组。治疗前1 d,缓解组外周血Th17细胞比例、Th17/Treg比值均低于未缓解组,Treg细胞比例高于未缓解组(P<0.05)。结论:外周血Th17/Treg失衡与儿童免疫性血小板减少症严重程度存在关联,有助于评估预后,可能成为早期评估病情的理想指标。
Objective:To analyze the relationship among peripheral blood Th17/Treg imbalance and severity and prognosis of immune thrombocytopenia in children.Method:A total of 65 children with immune thrombocytopenia admitted to Xuzhou Children’s Hospital from January 2017 to September 2021 were selected as the research objects.According to the severity of the disease,they were divided into severe group(30 cases,platelet count<10×10^(9)/L)and non severe group(35 cases,platelet count≥10×10^(9)/L).All children were treated with the gamma globulin and glucocorticoid,and they were tested for peripheral blood indicators(the proportions of Th17 cells and Treg cells and the peripheral blood Th17/Treg ratio)and inflammatory factors(serum IL-4,IL-6,IL-10,IL-17).The peripheral blood indexes and inflammatory factors were compared between severe group and non severe group.Pearson correlation was used to analyze the relationship among peripheral blood Th17/Treg ratio and platelet count and onset time.The children were divided into groups according to whether the condition was relieved.The peripheral blood indexes of remission group and non remission group were compared 1 d before treatment.Result:The proportion of Th17 cell and Th17/Treg ratio in peripheral blood of severe group were higher than those of non severe group,and the proportion of Treg cells was lower than that of non severe group(P<0.05).The levels of serum IL-4 and IL-10 in severe group were lower than those in non severe group,and the levels of IL-6 and IL-17 in severe group were higher than those in non severe group(P<0.05).According to Pearson correlation analysis,the Th17/Treg ratio in peripheral blood was negatively correlated with platelet count(r=-0.784,P=0.000),and positively correlated with the onset time(r=0.691,P=0.000).All children completed the treatment,52 cases were in remission within 3 months of treatment,and they were included in the remission group,13 cases were not in remission,and they were included in the non remission group.One day before treat
作者
黄宝山
HUANG Baoshan(Xuzhou Children’s Hospital,Xuzhou 221000,China)
出处
《中外医学研究》
2022年第25期76-79,共4页
CHINESE AND FOREIGN MEDICAL RESEARCH
