临床肝胆病杂志2017，Vol.33Issue(1)：150-154,5.DOI:10.3969/j.issn.1001-5256.2017.01.033
原发性免疫性血小板减少症患者脾切除术前T 淋巴细胞亚群检测的临床意义
Clinical significance of measurement of T lymphocyte subsets before splenectomy in patients with primary immune thrombocytopenia
黎建云 1涂传清 1贺德 2王典文 1黄灿 1张旭艳 1冯春1
作者信息
- 1. 深圳市宝安区人民医院 血液内科，广东 深圳 518101
- 2. 深圳市宝安区人民医院 普通外科一区，广东 深圳 518101
- 折叠
摘要
Abstract
Objective To investigate the changes in lymphocyte subsets and natural killer (NK)cells before splenectomy in patients with primary immune thrombocytopenia (ITP)who have no response to corticosteroid therapy or experience recurrence after drug withdrawal,as well as their association with early ITP recurrence after splenectomy.Methods A total of 32 patients with ITP who were treated with sple-nectomy in The People′s Hospital of Bao′an District from January 2009 to December 2015 and followed up for 3 -60 months were enrolled and divided into early recurrence group (with recurrence within 6 months after splenectomy and platelet count <30 ×109 /L)and response group (platelet count >30 ×109 /L after splenectomy,two -fold increase compared with before splenectomy)according to the outcome of splenectomy.Flow cytometry was used to measure the percentages of peripheral blood lymphocyte subsets (CD3 +CD4 +,CD3 +CD8 +, CD3 +CD4 +/CD3 +CD8 +,and CD3 -CD19 +)and CD56 +CD16 + NK cells before splenectomy.The t -test was used for comparison of continuous data between groups and the chi -square test or Fisher′s exact test was used for comparison of categorical data between groups. Results There were 11 patients (11 /32,34.4%)in the early recurrence group and 21 (21 /32,65.6%)in the response group.Com-pared with the response group,the early recurrence group had a significantly lower percentage of CD3 +CD4 +(21.7% ±5.4% vs 32.6% ± 4.1%,t =6.39,P =0.015)and a significantly lower CD3 +CD4 +/CD3 +CD8 + ratio (0.65 ±0.21 vs 1.29 ±0.36,t =3.92,P =0.003),as well as a significantly higher percentage of〗CD3 +CD8 +T cells (34.5% ±5.9% vs 26.8% ±6.6%,t =-3.20,P =0.030) before splenectomy.There were no significant differences in CD3 -/CD16 +CD56 + ratio and the percentage of CD3 -CD19 + T cells be-tween the two groups (both P >0.05).Conclusion ITP patients with a low percentage of CD3 +CD4 + T cells and a low CD3 +CD4 +/CD3 +CD8 + ratio before splenectomy tend to experience recurrence after surgery,which suggests that abnormal T lymphocyte subsets can be used as one of the reference indices for predicting the clinical outcome of splenectomy in ITP patients.关键词
血小板减少/脾切除术/T 淋巴细胞亚群/杀伤细胞,天然Key words
thrombocytopenia/splenectomy/T -lymphocyte subsets/killer cells,natural分类
医药卫生引用本文复制引用
黎建云,涂传清,贺德,王典文,黄灿,张旭艳,冯春..原发性免疫性血小板减少症患者脾切除术前T 淋巴细胞亚群检测的临床意义[J].临床肝胆病杂志,2017,33(1):150-154,5.
