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目的探讨特发性血小板减少性紫癜(ITP)患儿细胞免疫功能的变化及其临床意义。方法将2013年8月~2015年7月在笔者医院儿科住院的83例ITP初治患儿及31例同期在笔者医院门诊体检的健康同龄儿纳入研究,采用流式细胞术检测外周血T淋巴细胞亚群CD3、CD4、CD8、CD4/CD8比例,采用酶联免疫吸附试验检测血浆细胞因子IFN-γ及IL-4浓度。结果治疗前病例组CD3 60.07%±11.85%、CD4 34.18%±11.72%、CD4/CD8 1.76%±0.94%及IL-4 11.24±8.42pg/ml水平显著低于对照组70.96%±7.26%、45.05%±6.53%,2.26%±0.66%及21.26±9.34pg/ml,IFN-γ水平5.88±4.02pg/ml显著高于对照组2.12±1.09pg/ml;治疗后8周后,CD3 65.76%±10.87%、CD4 38.71%±11.81%及IL-4 14.59±11.59pg/ml水平均较治疗前升高,IFN-γ3.65±3.15pg/ml水平均较治疗前降低,差异有统计学意义(P<0.01或P<0.05)。结论 ITP患儿存在细胞免疫功能紊乱,Th1/Th2平衡失调可能与ITP的发病机制和疾病的活动状态密切相关。
Objective To investigate the changes of cellular immune function in children with idiopathic thrombocytopenic purpura (ITP) and its clinical significance. Methods From August 2013 to July 2015, 83 children with ITP who were hospitalized in the hospital pediatric department and 31 healthy children of the same age who were hospitalized in the hospital during the same period were enrolled in this study. Flow cytometry was used to detect peripheral blood T lymphocytes The proportions of CD3, CD4, CD8 and CD4 / CD8 were detected by enzyme-linked immunosorbent assay. The levels of IFN-γ and IL-4 in plasma were measured. Results Before treatment, the level of CD3 was 60.07% ± 11.85%, CD4 34.18% ± 11.72%, CD4 / CD8 1.76% ± 0.94% and IL-4 11.24 ± 8.42pg / ml significantly lower than that of the control group 70.96% ± 7.26%, 45.05 % ± 6.53%, 2.26% ± 0.66% and 21.26 ± 9.34pg / ml, IFN-γ level 5.88 ± 4.02pg / ml was significantly higher than the control group 2.12 ± 1.09pg / ml; After 8 weeks of treatment, CD3 65.76% ± 10.87%, CD4 38.71% ± 11.81%, and IL-4 14.59 ± 11.59pg / ml were all higher than those before treatment, and the levels of IFN-γ3.65 ± 3.15pg / ml were lower than those before treatment P <0.01 or P <0.05). Conclusions There are cellular immune dysfunction in children with ITP. The imbalance of Th1 / Th2 may be closely related to the pathogenesis of ITP and the activity of the disease.