[1]王欣欣,刘　豹,郭路阳,等.T淋巴细胞相关细胞因子在儿童免疫性血小板减少症转归中的意义[J].新乡医学院学报,2019,36(9):864-867.[doi:10.7683/xxyxyxb.2019.09.014]
　WANG Xin-xin,LIU Bao,GUO Lu-yang,et al.Significance of T lymphocyte-related cytokines in the prognosis of immune thrombocytopenia in children[J].Journal of Xinxiang Medical University,2019,36(9):864-867.[doi:10.7683/xxyxyxb.2019.09.014]
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T淋巴细胞相关细胞因子在儿童免疫性血小板减少症转归中的意义
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
36
期数:
2019年9
页码:
864-867
栏目:
临床研究
出版日期:
2019-09-05

文章信息/Info

Title:
Significance of T lymphocyte-related cytokines in the prognosis of immune thrombocytopenia in children
作者:
王欣欣; 刘　豹; 郭路阳; 范　蕊; 任瑞娟; 李培岭; 石太新
（新乡医学院第一附属医院儿科，河南　卫辉　453100）
Author(s):
WANG Xin-xin; LIU Bao; GUO Lu-yang; FAN Rui; REN Rui-juan; LI Pei-ling; SHI Tai-xin
（Department of Pediatrics，the First Affiliated Hospital of Xinxiang Medical University，Weihui 453100，Henan Province，China）
关键词:
原发性免疫性血小板减少症; T淋巴细胞相关细胞因子; 流式微球阵列技术
Keywords:
primary immune thrombocytopenia; T lymphocyte-related cytokines; cytometric bead array
分类号:
R725.5
DOI:
10.7683/xxyxyxb.2019.09.014
文献标志码:
A
摘要:
目的　检测原发性免疫性血小板减少症（ITP）患儿外周血T淋巴细胞相关细胞因子水平，分析其在儿童ITP患儿临床预后评估中的意义。方法　选择2016年7月至2017年12月新乡医学院第一附属医院儿内科收治的ITP患儿108例为研究对象，根据病情转归分为新诊断ITP组（n=67）、持续性ITP组（n=25）及慢性ITP组（n=16）；选择同期体检健康儿童40例作为对照组。采用流式微球阵列技术（CBA）检测ITP患儿治疗前、慢性ITP患儿治疗后12个月及对照组受试者血清白细胞介素-2（IL-2）、干扰素-γ（IFN-γ）、肿瘤坏死因子（TNF）、IL-4、IL-6、IL-10、IL-17A水平，分析其与儿童ITP预后的关系。结果　新诊断ITP组、持续性ITP组、慢性ITP组患儿血清IL-2、IL-17A水平高于对照组（P<0.05），慢性ITP组患儿血清IL-2水平高于新诊断ITP组、持续性ITP组（P<0.05），慢性ITP组患儿血清IL-17A水平高于新诊断ITP组（P<0.05）；新诊断ITP组、持续性ITP组、慢性ITP组患儿血清IL-4、IL-10水平低于对照组（P<0.05），慢性ITP组患儿血清IL-4、IL-10水平低于新诊断ITP组（P<0.05）；4组受试者血清IFN-γ、TNF、IL-6水平比较差异均无统计学意义（P>0.05）。慢性ITP患儿治疗后12个月血清IL-2、IL-6、INF-γ、IL-4、IL-10、TNF、IL-17A 水平与治疗前比较差异均无统计学意义（P>0.05）。结论　ITP患儿血清IL-2、IL-17A水平升高，IL-4、IL-10水平降低，在慢性ITP患儿更显著，可能提示与疾病呈慢性发展有关，有助于判断ITP患儿病情转归。
Abstract:
Objective　To detect the levels of T lymphocyte-related cytokines in peripheral blood of children with primary immune thrombocytopenia （ITP） and analyze their significance in the clinical prognosis of children with ITP.Methods　A total of 108 children with ITP who were treated in Department of Pediatrics，the First Affiliated Hospital of Xinxiang Medical University from July 2016 to December 2017 were selected as the study subjects.According to the outcome of the disease，they were divided into newly diagnosed ITP group （n=67），persistent ITP group （n=25） and chronic ITP group （n=16）.Another 40 healthy children with physical examination in the hospital were selected as the control group during the same period.The serum levels of interleukin-2 （IL-2），interferon-γ （IFN-γ），tumor necrosis factor （TNF），interleukin-4 （IL-4），interleukin-6 （IL-6），interleukin-10 （IL-10），interleukin-17A （IL-17A） in children with ITP before treatment，in children with chronic ITP at 12 months after treatment，and in the control group were detected by cytometric bead array.The relationship between cytokines and prognosis of children with ITP was analyzed.Results　The levels of IL-2 and IL-17A in the newly diagnosed ITP group，persistent ITP group and chronic ITP group were higher than those in the control group （P<0.05），and the level of IL-2 in the chronic ITP group was higher than that in the newly diagnosed ITP group and persistent ITP group （P<0.05）；the level of IL-17A in the chronic ITP group was higher than that in the newly diagnosed ITP group （P<0.05）.The levels of IL-4 and IL-10 in the newly diagnosed ITP group，persistent ITP group and chronic ITP group were lower than those in the control group （P<0.05），and the levels of IL-4 and IL-10 in the chronic ITP group were lower than those in the newly diagnosed ITP group （P<0.05）.There was no statistically significant differences in the serum IFN-γ，TNF and IL-6 levels among the four groups （P>0.05）.There was no statistic difference in the serum levels of IL-2，IL-6，IFN-γ，IL-4，IL-10，TNF and IL-17A in the chronic ITP group before treatment and at 12 months after treatment （P>0.05）.Conclusion　The serum levels of IL-2 and IL-17A are increased，and the levels of IL-4 and IL-10 are decreased in the children with ITP，the changes are significant in chronic patients，which may be related to the chronic development of the disease，and help to judge the outcome of ITP patients.

参考文献/References:

［1］　MOULIS G，LAPEYRE-MESTRE M，ADOUE D.Epidemiology and pharmacoepidemiology of immune thrombocytopenia［J］.Rev Med Interne，2017，38（7）：444-449.
［2］　任瑞娟，石太新，赵东菊，等.儿童免疫性血小板减少症360例临床特征分析［J］.中国小儿血液与肿瘤杂志，2015，20（1）：41-44.
［3］　BENNETT C M，NEUNERT C，GRACE R F，et al.Predictors of remission in children with newly diagnosed immune thrombocytopenia：data from the Intercontinental Cooperative ITP Study Group Registry II participants［J］.Pediatr Blood Cancer，2018，65（1）：1-7.
［4］　中华医学会儿科分会血液组，《中华儿科杂志》编辑委员会.儿童原发性免疫性血小板减少症诊疗建议［J］.中华儿科杂志，2013，51（5）：382-384.
［5］　谢晓恬.儿童免疫性血小板减少症发病机制与诊治研究进展［J］.中国小儿血液与肿瘤杂志，2017，22（1）：51-54.
［6］　PERERA M.Advances in the pathophysiology of primary immune thrombocytopenia［J］.Hematology，2017，22（1）：41-53.
［7］　MCKENZIE C G，GUO L，FREEDMAN J.Cellular immune dysfun-ction in immune thrombocytopenia （ITP）［J］.Br J haematol，2013，163（1）：10-23.
［8］　李培岭，石太新，赵东菊，等.急性特发性血小板减少性紫癜患儿T细胞亚群、NK细胞及IFN-γ、IL-4变化的探讨［J］.中国小儿血液与肿瘤杂志，2013，18（4）：180-183.
［9］　郭新红，赵芳，石伟，等.特发性血小板减小性紫癜患者Th1/Th2的细胞因子水平及临床意义［J］.细胞与分子免疫学杂志，2012，28（11）：1185-1187.
［10］　李文倩，王小蕊，李建平，等.免疫性血小板减少症患者免疫抑制治疗前后免疫细胞亚群及细胞因子谱分析［J］.中华内科学杂志，2016，55（2）：111-115.
［11］　MA L，LIANG Y，FANG M，et al.The cytokines （IFN-gamma，IL-2，IL-4，IL-10，IL-17） and Treg cytokine （TGF-beta1） levels in adults with immune thrombocytopenia［J］.Die Pharmazie，2014，69（9）：694-697.
［12］　YE X，ZHANG L，WANG H，et al.The role of IL-23/Th17 pathway in patients with primary immune thrombocytopenia［J］.PLoS One，2015，10（1）：1-13.
［13］　王颖超，刘满菊，朱桂英，等.Th1/Th2细胞比例失衡在儿童原发性免疫性血小板减少症中的意义［J］.中国当代儿科杂志，2016，18（3）：238-242.
［14］　MA D，ZHU X，ZHAO P，et al.Profile of Th17 cytokines （IL-17，TGF-beta，IL-6） and Th1 cytokine（IFN-gamma） in patients with immune thrombocytopenic purpura［J］.Ann Hematol，2008，87（11）：899-904.
［15］　GUO Z X，CHEN Z P，ZHENG C L，et al.The role of Th17 cells in adult patients with chronic idiopathic thrombocytopenic purpura［J］.Eur J Haematol，2009，82（6）：488-489.
［16］　ROCHA A M，SOUZA C，ROCHA G A，et al.The levels of IL-17A and of the cytokines involved in Th17 cell commitment are increased in patients with chronic immune thrombocytopenia［J］.Haematologica，2011，96（10）：1560-1564.
［17］　马静瑶，吴润晖，陈振萍，等.儿童原发性免疫性血小板减少症初发病例T辅助细胞因子表达水平意义初探［J］.血栓与止血学，2013，9（3）：110-117.

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更新日期/Last Update: 2019-09-05