论文部分内容阅读
目的探讨加用全反式维甲酸(ATRA)对难治性特发性血小板减少性紫癜(RITP)的疗效及对患者外周血调节性T(CD4+CD25highT)细胞表达和辅助性T(Th)细胞因子的影响。方法应用流式细胞术测定28例RITP患者ATRA治疗前后及17名正常人外周血CD4+CD25highT细胞的表达;ELISA法测定血清中转化生长因子β1(TGF-β1)、白介素10(IL-10)、IL-4、IL-2、干扰素γ(IFN-γ)。结果ATRA对RITP总有效率为53.6%。治疗有效组治疗后患者外周血小板计数从(25.7±9.6)×109/L升至(109.1±30.1)×109/L(P<0.01),差异有高度统计学意义(P<0.01);有效组治疗后患者CD4+CD25highT细胞阳性率及血清TGF-β1、IFN-γ水平明显高于治疗前,IL-4则明显低于治疗前,差异均有统计学意义(均P<0.05);IL-2和IL-10在治疗后未见改变。结论ATRA对半数以上RITP患者有效,可能是通过提高调节性T细胞的表达,促进了RITP患者的免疫紊乱向生理性平衡恢复。
Objective To investigate the therapeutic effect of ATRA on refractory idiopathic thrombocytopenic purpura (RITP) and on the expression of T (CD4 + CD25highT) and T (Th) Effects of cytokines. Methods Flow cytometry was used to detect the expression of CD4 + CD25highT cells in peripheral blood of 28 RITP patients before and after treatment with ATRA and 17 normal controls. The levels of TGF-β1, IL-10, , IL-4, IL-2, interferon gamma (IFN-γ). Results The total effective rate of ATRA to RITP was 53.6%. Peripheral platelet count increased from (25.7 ± 9.6) × 109 / L to (109.1 ± 30.1) × 109 / L (P <0.01) in the treatment-effective group, the difference was statistically significant (P <0.01) After treatment, the positive rates of CD4 + CD25high T cells and the levels of serum TGF-β1 and IFN-γ were significantly higher than those before treatment, while the levels of IL-4 were significantly lower than those before treatment (all P <0.05) 2 and IL-10 did not change after treatment. Conclusion ATRA is effective in more than half of patients with RITP, which may promote the recovery of immune balance in patients with RITP by adjusting the expression of regulatory T cells.