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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

黎建云 涂传清 贺德 王典文 黄灿 张旭艳 冯春

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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

DOI: 10.3969/j.issn.1001-5256.2017.01.033
详细信息
  • 中图分类号: R558.2;R657.6

Clinical significance of measurement of T lymphocyte subsets before splenectomy in patients with primary immune thrombocytopenia

  • 摘要:

    目的分析激素治疗无效或停药后复发的原发性免疫性血小板减少症(ITP)患者脾切除术前T淋巴细胞亚群、自然杀伤细胞的变化,探讨其与脾切除后ITP早期复发的关系。方法收集2009年1月-2015年12月于深圳市宝安区人民医院治疗的ITP脾切除患者32例,随访时间360个月,按脾切除疗效分为早期复发组(脾切除后6个月内复发,PLT<30×109 plt="">30×109/L且较切除前PLT增加2倍以上)。应用流式细胞技术检测患者脾切除术前外周血T淋巴细胞亚群(CD3+CD4+、CD3+CD8+、CD3+CD4+/CD3+CD8+、CD3-CD19+)及CD56+CD16+自然杀伤细胞的百分比(CD3-/CD16+CD56+)。计量资料组间比较采用t检验,计数资料组间比较采用χ2检验或Fisher检验。结果早期复发组患者11例(占34.4%),有效组21例(占65.6%)。早期复发组脾切除术前CD3+CD4+、CD3+CD4+/CD3+CD8+明显低于有效组[(21.7±5.4)%vs(32.6±4.1)%,t=6.39,P=0.015;0.6...

     

  • [1]ZHOU X,YAN X.Clinical efficacy of laparoscopic splenectomy for immune thrombocytopenic purpura[J].Chin J Dig Surg,2015,14(9):746-749.(in Chinese)周雄,阎雄.腹腔镜脾切除术治疗免疫性血小板减少性紫癜的临床疗效[J].中华消化外科杂志,2015,14(9):746-749.
    [2] Thrombosis and Hemostasis Group,Hematology Society.Consensus of Chinese experts on diagnosis and treatment of adult primary immune thrombocytopenia(version 2016)[J].Chin J Hematol,2016,37(2):89-93.(in Chinese)中华医学会血液学分会止血与血栓学组.成人原发免疫性血小板减少症诊断与治疗中国专家共识(2016年版)[J].中华血液学杂志,2016,37(2):89-93.
    [3] LI Y,LI H,WANG L,et al.Efficacy and feasibility of laparoscopic splenectomy in patients with a low platelet count[J].Chin J Hepatobiliary Surg,2016,22(2):107-110.(in Chinese)李扬,李灏,王磊,等.血小板减少患者行腹腔镜脾切除的可行性及疗效[J].中华肝胆外科杂志,2016,22(2):107-110.
    [4]ZHANG H,WU ZJ,YAN X,et al.Laparoscopic splenectomy for idiopathic thrombocytopenic purpura:a clinical analysis of 62 cases[J].J Clin Surg,2016,24(8):602-604.(in Chinese)张华,吴忠均,阎雄,等.腹腔镜脾切除术治疗特发性血小板减少性紫癜62例临床分析[J].临床外科杂志,2016,24(8):602-604.
    [5]MIKHAEL J,NORTHRIDGE K,LINDQUIST K,et al.Shortterm and long-term failure of laparoscopic splenectomy in adult immune thrombocytopenic purpura patients:a systematic review[J].Am J Hematol,2009,84(11):743-748.
    [6]TOMIYAMA Y,KOSUGI S.Autoantigenic epitopes on platelet glycoproteins[J].Int J Hematol,2005,81(2):100-105.
    [7]Mc MILLAN R,WANG L,TANI P.Prospective evaluation of the immunobead assay for the diagnosis of adult chronic immune thrombocytopenic purpura(ITP)[J].J Thromb Haemost,2003,1(3):485-491.
    [8]KASHIWAGI H,TOMIYAMA Y.Pathophysiology and management of primary immune thrombocytopenia[J].Int J Hematol,2013,98(1):24-33.
    [9]SAKAGUCHI S.Naturally arising Foxp3-expressing CD25+CD4+regulatory T cells in immunological tolerance to self and non-self[J].Nat Immunol,2005,6(4):345-352.
    [10]NISHIMOTO T,KUWANA M.CD4+CD25+Foxp3+regulatory T cells in the pathophysiology of immune thrombocytopenia[J].Semin Hematol,2013,50(Suppl 1):s43-s49.
    [11]CHOW L,ASLAM R,SPECK ER,et al.A murine model of severe immune thrombocytopenia is induced by antibody-and CD8+T cell-mediated responses that are differentially sensitive to therapy[J].Blood,2010,115(6):1247-1253.
    [12]PARK YH,YI HG,KIM CS,et al.Clinical outcome and predictive factors in the response to splenectomy in elderly patients with primary immune thrombocytopenia:a multicenter retrospective study[J].Acta Haematol,2016,135(3):162-171.
    [13]ZHENG CX,JI ZQ,ZHENG D,et al.Value for detection of peripheral blood T-lymphocyte subsets before and after splenectomy in patients with immune thrombocytopenic purpura[J/CD].Chin J Clinicians:Electronic Edition,2010,4(10):1808-1812.(in Chinese)郑朝旭,纪壮奇,郑冬,等.免疫性血小板减少性紫癜患者脾切除术前后外周血T细胞亚群的检测意义[J/CD].中华临床医师杂志:电子版,2010,4(10):1808-1812.
    [14]MA LF,WANG CY,WANG R,et al.Changes of T lymphocyte subsets in patients with idiopathic thrombocytopenic purpura after laparoscopic splenectomy[J].Clin Med China,2015,31(4):340-342.(in Chinese)马利锋,王晨宇,王若,等.特发性血小板减少性紫癜患者腹腔镜脾切除术后T淋巴细胞亚群的变化[J].中国综合临床,2015,31(4):340-342.
    [15]CURRAO M,BALDUINI CL,BALDUINI A.High doses of romiplostim induce proliferation and reduce proplatelet formation by human megakaryocytes[J].PLo S One,2013,8(1):e54723.
    [16]LIU XG,LIU S,FENG Q,et al.Thrombopoietin receptor agonists shift the balance of Fcγreceptors toward inhibitory receptorⅡb on monocytes in ITP[J].Blood,2016,128(6):852-861.
    [17]KUTER DJ,BUSSEL JB,NEWLAND A,et al.Long-term treatment with romiplostim in patients with chronic immune thrombocytopenia:safety and efficacy[J].Br J Haematol,2013,161(3):411-423.
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