摘要
目的探讨Ｔ淋巴细胞亚群、白细胞介素１０（ＩＬ１０）、γ干扰素（ＩＦＮγ）在特发性血小板减少性紫癜（ＩＴＰ）中的变化及其用地塞米松（ＤＥＸ）治疗的影响。方法采用ＤＥＸ治疗ＩＴＰ患儿，分别于治疗前后采取静脉血标本，应用改良碱性磷酸酶抗碱性磷酸酶（ＡＰＡＡＰ）法及酶标记免疫吸附测定（ＥＬＩＳＡ）法分别检测Ｔ细胞亚群及血清ＩＬ１０、ＩＦＮγ的含量。结果ＩＴＰ患儿ＤＥＸ治疗前外周血ＣＤ＋４降低，ＣＤ＋８升高，ＣＤ＋４／ＣＤ＋８显著降低；ＤＥＸ治疗后ＣＤ＋４、ＣＤ＋８均降低，其中以ＣＤ＋８降低尤为显著，但ＣＤ＋４／ＣＤ＋８明显高于治疗前。ＩＴＰ患儿ＤＥＸ治疗前血清ＩＦＮγ显著升高，治疗后则降至正常水平，ＩＦＮγ与外周血小板计数呈显著负相关，但与Ｔ淋巴细胞亚群无显著相关性。ＩＴＰ患儿ＤＥＸ治疗前血清ＩＬ１０显著降低，治疗后升高，ＩＴＰ患儿血清ＩＬ１０与外周血血小板计数呈显著正相关，但与Ｔ淋巴细胞亚群无显著相关性。结论ＩＴＰ患儿Ｔ淋巴细胞亚群表达及比例失调，ＩＦＮγ产生增多，ＩＬ１０产生减少，提示辅助Ｔ淋巴细胞亚型（Ｔｈ１／Ｔｈ２）功能异常。ＤＥＸ治疗ＩＴＰ能有效缓解病情。
Objective To investigate the changes in T lymphocyte subsets, interleukin 10 (IL 10) and gamma interferon (IFN γ) in patients with idiopathic thrombocytopenic purpura (ITP) and the effect of dexamethasone (DEX) treatment. Methods The blood samples were collected in ITP patients prior and post DEX treatment. T lymphocyte subsets of peripheral blood were examined by using APAAP method, and serum IL 10, IFN γ levels were measured by using ELISA assay. Additionally, 12 healthy volunteers served as normal controls. Results Compared to normal controls, these ITP patients showed an elevation in percentage of CD + 8 cells, but decrease in CD + 4 cells as well as ratio of CD + 4/CD + 8 in peripheral blood. After DEX treatment, the expression of both CD + 4 cells and CD + 8 cells was profoundly inhibited, especially for CD + 8 cells, while the ratio of CD + 4/CD + 8 was significantly increased. Serum levels of IFN γ increased obviously in children with ITP and negatively correlated with platelet counts, but they were reduced by DEX. However, serum levels of IL 10, which were diminished in these patients and positively correlated with platelet counts, were increased after DEX treatment. Nevertheless, no marked correlation was found between IFN γ or IL 10 levels and T lymphocyte subsets. Conclusion In ITP patients, abnormal distribution of T lymphocyte subsets and changes in serum IFN γ, IL 10 levels may imply the dysfunction of Th1/Th2. Treatment with DEX has beneficial effect on ITP, which appears to be associated with the regulation of T lymphocyte subsets expression and cytokine production.
出处
《中华儿科杂志》
CAS
CSCD
北大核心
1999年第1期12-14,共3页
Chinese Journal of Pediatrics
关键词
紫癜
血小板减少性
T细胞
IL-10
Purpura, thrombocytopenic, idiopathic T lymphocyte subsets Interleukin 10 Gamma interferon
