摘要
目的探讨免疫性血小板减少性紫癜(ITP)脾切除血液学疗效与脾脏细胞免疫的关系。方法应用免疫组织化学技术,采用抗人CD3、CD4、CD8单克隆抗体和抗人S100多克隆抗体,分别检测33例脾切除有效(A组)和14例脾切除无效(B组)的ITP患者的脾脏组织标本CD3+细胞、CD4+细胞、CD8+细胞和S100+细胞的表达情况,对照组为12例因外伤性脾破裂行脾切除术的脾脏组织标本(C组)。显微镜下观察脾脏组织动脉周围淋巴鞘(PALS)中染色阳性细胞的百分数,并计算CD4+/CD8+比值。分析3组CD3+、CD4+、CD8+、S100+细胞百分数和CD4+/CD8+细胞比值的差异。结果 3组PALS中CD3+、CD4+细胞百分数差异均无统计学意义;A组CD8+细胞百分数高于B组(P=0.001)和C组(P<0.01),而C组PALS中CD4+/CD8+比值分别高于A组(P=0.001)和B组(P=0.001);A组PALS中S100+细胞百分数高于B组(P=0.015)。结论 ITP患者脾脏细胞免疫存在异常。脾切除血液学疗效与脾脏细胞免疫异常有密切关系。
Objective To investigate the relationship between the hematological outcomes of splenectomy and the abnormal cellular immunity of the spleen in patients with immune thrombocytopenic purpura （ITP）.Methods With the monoclonal antibody of the anti-human CD3,CD4,CD8 and the polyclonal antibody of the anti-human S100,the expression of the CD3＋,CD4＋,CD8＋ and S100＋cell in the specimens of the spleen tissue were detected by the immuohistochemistry method from 33 ITP patients who had response to splenectomy （group A） and 14 cases who had no response to splenectomy （group B）.The specimens of the spleen tissue of 12 cases who underwent emergency splenectomy for traumatic rupture of spleen was served as the control group （group C）.The percentages of the positive staining cells around the periarterial lymphatic sheath （PALS） of the spleen were counted under the microscope.The ratio of the percentage of CD4＋cell and CD8＋cell was calculated.The differences in the percentages of CD3,CD4,CD8 and S100 positive staining cells,as well as CD4＋/CD8＋ ratio,were analyzed among the three groups.Results No significant difference of the percentage of CD3＋ cell and CD4＋ cell was found amongthe three groups.The percentage ofthe CD8＋ cell in the group A was significantlyhigher than that in the group B（P=0.001） and group C（P0.01）.And CD4＋/CD8＋ ratio in the group C was also higher than that in the group A （P=0.001） and group B（P=0.01）.There was significant difference in the percentages of the S100＋ cell between group A and the group B（P=0.015）.Conclusions Abnormal cellular immunity of spleen is found in patients with ITP.There isclose relationship between the hematological outcomes of splenectomy and the abnormal cellular immunity of the spleen.
出处
《中华普通外科学文献（电子版）》
2010年第4期57-60,共4页
Chinese Archives of General Surgery(Electronic Edition)
基金
广东省科技计划项目资助(2008B080703033)
广东省自然科学基金项目(9151008901000061)
