急慢性ITP患儿外周血调节性T细胞及其相关细胞因子的表达及意义
发布时间：2018-10-25 08:53
【摘要】：目的:检测急性原发性免疫性血小板减少症(acute primary immune thrombocytopenia,AITP)、慢性原发性免疫性血小板减少症(chronic primary immune thrombocytopenia,CITP)患儿外周血CD4~+CD25~+CD127~-调节性T细胞(regulation T cell,Treg细胞)、转化生长因子(transforming growth factorβ1,TGF-β1)、白介素(interleukin,IL-10)的含量,讨论三者在ITP发生与发展中的作用机理。方法:入选符合ITP诊断标准的2015年1月至2016年6月期间在山西省儿童医院血液科住院和门诊诊治的ITP患儿66例,根据病程分为AITP组、CITP组,AITP组为初诊的未使用人免疫球蛋白及激素治疗的ITP患儿35例,CITP组为病程大于12个月的ITP患儿31例,依据病情将初诊的35例AITP患儿分为重型ITP组11例和非重型ITP组24例,正常对照组为本院2016年1月至3月体检中心健康儿童20例。用流式细胞术(FCM)分别检测AITP组、CITP组、重型ITP组、非重型ITP组及健康对照儿童外周血CD4~+CD25~+CD127~-百分率及血清IL-10含量,血清中TGF-β1含量用ELISA方法测得,并进行各组间比较及相关性分析。结果:1.定量检测表明,急性组CD4~+CD25~+CD127~-Treg百分率(4.23±0.82)%显著低于对照组(5.05±0.90)%(P0.01),慢性组CD4~+CD25~+CD127~-Treg百分率(3.47±0.63)%显著低于急性组(4.23±0.82)%(P0.01)。急性组TGF-β1水平(189.36±66.71)Pg?ml-1低于对照组(231.45±113.89)Pg?ml-1(P0.05),急性组IL-10含量(34.07±11.57)Pg?ml-1低于对照组(43.83±10.96)Pg?ml-1(P0.05),TGF-β1及IL-10含量慢性组低于急性组(P0.01)。非重型ITP组CD4~+CD25~+CD127~-Treg百分率(4.55±0.90)%显著高于重型ITP组(4.14±0.58)%(P0.05),非重型ITP组TGF-β1水平(210.25±73.65)Pg?ml-1未明显高于重型ITP组(188.16±57.7)Pg?ml-1(P0.05),非重型ITP组IL-10含量(39.42±13.55)Pg?ml-1未明显高于重型ITP组(31.63±9.9)Pg?ml-1(P0.05)。2.相关性分析显示,ITP患儿CD4~+CD25~+CD127~-Treg百分率与TGF-β1含量呈正相关(r=0.75,P0.01)。ITP患儿外周血IL-10含量与CD4~+CD25~+CD127~-Treg百分率、TGF-β1含量则无相关性。结论:ITP患儿外周血Treg数目下降以及TGF-β1、IL-10含量降低可能与ITP患儿的细胞免疫调节功能紊乱相关,与调节性T细胞有关的免疫功能的改变在慢性组及重型ITP组中表现尤其明显,这可能是慢性ITP患儿在疾病过程中治疗效果不佳呈现长病程的原因之一。
[Abstract]:Objective: to detect the (regulation T cell,Treg cells of CD4~ CD25~ CD127~- regulatory T cells in peripheral blood of children with acute idiopathic thrombocytopenia (acute primary immune thrombocytopenia,AITP) and chronic idiopathic immune thrombocytopenia (chronic primary immune thrombocytopenia,CITP), transforming growth factor (transforming growth factor 尾 1 (TGF- 尾 1). The content of interleukin (interleukin,IL-10), The action mechanism of the three factors in the occurrence and development of ITP is discussed. Methods: 66 patients with ITP who met the diagnostic criteria of ITP in the Department of Hematology of Shanxi Children's Hospital from January 2015 to June 2016 were enrolled in this study. According to the course of disease, the patients were divided into three groups: AITP group, CITP group and AITP group. 35 cases of ITP were not treated with human immunoglobulin and hormone, and 31 cases of CITP group were ITP patients whose course of disease was longer than 12 months. According to the condition, 35 children with AITP were divided into severe ITP group (n = 11) and non-severe ITP group (n = 24). The normal control group consisted of 20 healthy children from January to March 2016. The percentage of CD4~ CD25~ CD127~- in peripheral blood and the content of IL-10 in serum of children in AITP group, CITP group, severe ITP group, non-severe ITP group and healthy control group were measured by flow cytometry (FCM). The TGF- 尾 1 content in serum was measured by ELISA method. The result is 1: 1. Quantitative analysis showed that the percentage of CD4~ CD25~ CD127~-Treg in acute group (4.23 卤0.82)% was significantly lower than that in control group (5.05 卤0.90)% (P0.01), and the percentage of CD4~ CD25~ CD127~-Treg in chronic group (3.47 卤0.63)% was significantly lower than that in acute group (4.23 卤0.82)% (P0.01). The level of TGF- 尾 1 in acute group (189.36 卤66.71) Pg?ml-1 was lower than that in control group (231.45 卤113.89) Pg?ml-1 (P0.05), IL-10 content in acute group (34.07 卤11.57) Pg?ml-1 was lower than that in control group (43.83 卤10.96) Pg?ml-1 (P0.05), TGF- 尾 1 and IL-10 content in chronic group was lower than that in acute group (P0.01). The percentage of CD4~ CD25~ CD127~-Treg in non-severe ITP group (4.55 卤0.90)% was significantly higher than that in severe ITP group (4.14 卤0.58)% (P0.05). The level of TGF- 尾 _ 1 in non-severe ITP group (210.25 卤73.65) was not significantly higher than that in severe ITP group (188.16 卤57.7) Pg?ml-1 (P0.05). IL-10 content in non-severe ITP group was (39.42 卤13.55) Pg?ml-1 was not significantly higher than that in severe ITP group (31.63 卤9.9) Pg?ml-1 (P0.05). Correlation analysis showed that there was a positive correlation between the percentage of CD4~ CD25~ CD127~-Treg and the content of TGF- 尾 _ 1 in children with ITP (r = 0.75 卤P0.01), but there was no correlation between the percentage of IL-10 and the percentage of CD4~ CD25~ CD127~-Treg in peripheral blood of children with). ITP, while the content of TGF- 尾 _ 1 was not. Conclusion: the decrease of Treg in peripheral blood and the decrease of TGF- 尾 1 IL-10 in peripheral blood of ITP children may be related to the disorder of cellular immune regulatory function in ITP children, especially in chronic and severe ITP groups. This may be one of the reasons for the long course of treatment in children with chronic ITP.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R725.5
[Abstract]:Objective: to detect the (regulation T cell,Treg cells of CD4~ CD25~ CD127~- regulatory T cells in peripheral blood of children with acute idiopathic thrombocytopenia (acute primary immune thrombocytopenia,AITP) and chronic idiopathic immune thrombocytopenia (chronic primary immune thrombocytopenia,CITP), transforming growth factor (transforming growth factor 尾 1 (TGF- 尾 1). The content of interleukin (interleukin,IL-10), The action mechanism of the three factors in the occurrence and development of ITP is discussed. Methods: 66 patients with ITP who met the diagnostic criteria of ITP in the Department of Hematology of Shanxi Children's Hospital from January 2015 to June 2016 were enrolled in this study. According to the course of disease, the patients were divided into three groups: AITP group, CITP group and AITP group. 35 cases of ITP were not treated with human immunoglobulin and hormone, and 31 cases of CITP group were ITP patients whose course of disease was longer than 12 months. According to the condition, 35 children with AITP were divided into severe ITP group (n = 11) and non-severe ITP group (n = 24). The normal control group consisted of 20 healthy children from January to March 2016. The percentage of CD4~ CD25~ CD127~- in peripheral blood and the content of IL-10 in serum of children in AITP group, CITP group, severe ITP group, non-severe ITP group and healthy control group were measured by flow cytometry (FCM). The TGF- 尾 1 content in serum was measured by ELISA method. The result is 1: 1. Quantitative analysis showed that the percentage of CD4~ CD25~ CD127~-Treg in acute group (4.23 卤0.82)% was significantly lower than that in control group (5.05 卤0.90)% (P0.01), and the percentage of CD4~ CD25~ CD127~-Treg in chronic group (3.47 卤0.63)% was significantly lower than that in acute group (4.23 卤0.82)% (P0.01). The level of TGF- 尾 1 in acute group (189.36 卤66.71) Pg?ml-1 was lower than that in control group (231.45 卤113.89) Pg?ml-1 (P0.05), IL-10 content in acute group (34.07 卤11.57) Pg?ml-1 was lower than that in control group (43.83 卤10.96) Pg?ml-1 (P0.05), TGF- 尾 1 and IL-10 content in chronic group was lower than that in acute group (P0.01). The percentage of CD4~ CD25~ CD127~-Treg in non-severe ITP group (4.55 卤0.90)% was significantly higher than that in severe ITP group (4.14 卤0.58)% (P0.05). The level of TGF- 尾 _ 1 in non-severe ITP group (210.25 卤73.65) was not significantly higher than that in severe ITP group (188.16 卤57.7) Pg?ml-1 (P0.05). IL-10 content in non-severe ITP group was (39.42 卤13.55) Pg?ml-1 was not significantly higher than that in severe ITP group (31.63 卤9.9) Pg?ml-1 (P0.05). Correlation analysis showed that there was a positive correlation between the percentage of CD4~ CD25~ CD127~-Treg and the content of TGF- 尾 _ 1 in children with ITP (r = 0.75 卤P0.01), but there was no correlation between the percentage of IL-10 and the percentage of CD4~ CD25~ CD127~-Treg in peripheral blood of children with). ITP, while the content of TGF- 尾 _ 1 was not. Conclusion: the decrease of Treg in peripheral blood and the decrease of TGF- 尾 1 IL-10 in peripheral blood of ITP children may be related to the disorder of cellular immune regulatory function in ITP children, especially in chronic and severe ITP groups. This may be one of the reasons for the long course of treatment in children with chronic ITP.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R725.5
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