论文标题:特发性血小板减少性紫癜外周血淋巴细胞共刺激分子、淋巴细胞亚群的表达及意义的研究
Expression of Costimulatory Molecules and Lymphocyte Subsets on Peripheral Lymphocytes in Patients with Idiopathic Thrombocytopenic Purura
论文作者 张春梅
论文导师 赵春亭；滕清良,论文学位 硕士,论文专业 临床血液学
论文单位 青岛大学,点击次数 96,论文页数 46页File Size3526k
2004-02-01论文网 http://www.lw23.com/lunwen_206606232/ 紫癜,血小板减少性,特发性,共刺激分子,淋巴细胞亚群,淋巴细胞
Purura, Thrombocytopenic,Idiopathic;Costimulatory Molecules; Lymphocyte Subsets;Peripheral Lymphocytes
目的：研究共刺激分子、淋巴细胞亚群在特发性血小板减少性紫癜(ITP)外周血淋巴细胞的表达及与临床的关系，以探讨ITP的发病机制。材料与方法：应用免疫荧光标记及流式细胞术检测28例ITP患者及15例正常对照者外周血淋巴细胞CD80、CD28、CD86、淋巴细胞亚群的表达；应用ELISA方法检测患者PAIgG水平；结果进行统计学处理，同时与患者的PAIgG、发病时间、就诊时血小板数值、治疗起效时间及骨髓巨核细胞数值进行相关性分析。结果：(1)ITP患者外周血淋巴细胞CD28的表达率降低，CD80的表达率略增加，但与对照无统计学差异；CD86的表达率明显增高，与正常对照组有显著差异(p＜0.01)。(2)ITP患者外周血淋巴细胞亚群的表达中，CD19+的表达率明显增加(p＜0.01)；CD3+、CD3+CD4+、CD3+CD4+／CD3+CD8+的比值、CD3-CD16+CD56+(NK细胞)的表达率明显降低(p＜0.05)。(3)患者PAIgG的测定结果：28例ITP患者中有21例PAIgG含量增高，均值为(197.39±67.81)ng／10~7血小板。(4)ITP患者外周血淋巴细胞CD86的表达率与患者的巨核细胞数值呈正相关(r=0.20，p＜0.05)。(5)患者外周血CD19+的表达率与患者发病时间呈正相关(r=0.62，p=0.01)，与患者骨髓巨核细胞数值呈正相关(r=0.61，p=0.01)；患者CD3+CD4+组的表达率与患者发病时间呈负相关(r=-0.51，p=004)；患者NK细胞的表达率与患者巨核细胞数值呈负相关(r=-0.55，p=0.03)。结论：ITP患者淋巴细胞亚群CD3+、CDl9+、CD3+CD4+、CD3+CD4+／CD3+CD8+的比值以及NK细胞的表达异常，表明ITP患者NK细胞的异常表达、细胞免疫功能及体液免疫功能的紊乱参与ITP的发病机制；ITP患者外周血淋巴细胞表面的共刺激分子CD28、CD80的表达无缺陷；但CD86的表达明显异常，表明共刺激分子CD86可能参与ITP的发病机制，提示应用抗CD86单克隆抗体或调节淋巴细胞亚群的方法有可能成为ITP的一种治疗手段。
Objective: To investigate the expression of costimulatory molecules and lymphocyte subsets on peripheral lymphocytes in patients with idiopathic thrombocytopenic purura(ITP) in order to research the pathogenesis of IIP. Methods: The expression of costimulatory molecules and lymphocyte subsets on the peripheral lymphocytes was measured by immunofluorescence and flow cytometry in 28 ITP patients and 15 normal subjects .The expression of PAIgG of ITP patients was analysed by ELISA method. Results: The expression of costimulatory molecules of CD28 and CD80 on the surface of peripheral lymphocytes was normal in ITP patients. Compared with normal controls, the expression of costimulatory molecule CD86 increased in ITP patients (p<0. 01).The expression of CD19+ was higher in ITP patients than in normal controls(p<0. 01), but the expression of CD3+, CD3+CD4+ CD3+CD4+/CD3+CD8+, CDS-CD16+CD56+ (NK cell) was lower in ITP patients than in normal controls (P<0. 05). The PAIgG level was higher in 21 ITP cases with a mean of (197. 39 + 67. 81) ng/107 pit. A positive correlation was found between the expression of CD86 and the number of megakaryocyte (r= 0. 20, p<0. 05) . The expression of CD19+ had positive correlation with the onset time (r= 0.62, p=0. 01) and the number of megakaryocyte (r=0. 61, p= 0.01) ,while the expression of CD3+CD4+ had negative correlation with the onset time (r=-0.51 , p=0. 04). We also observed that there was negative correlation between the expression of NK cells and the number of megakaryocyte (r=-0. 55, p= 0. 03) . Conclusions: Most of lymphocyte subsets expression in ITP patients were abnormal and the disorder of the cellular immunity , humoral immunity function and NK cells is involved in pathogenesis of ITP . The expression of CD28 and CD80 on the surface of peripheral lymphocytes in ITP patients had no deficiency, but the expression of CD86 on the surface of peripheral lymphocytes in ITPpatients increased and it may be related to the pathogenesis of IIP. Our research may provide a new way in the treatment of IIP with monoclonal antibody or regulating lymphocyte subsets.Postgraduate Zhang chunmei (clinical hematology) Directed by Prof.Zhao chunting , Prof. Teng qingliang
|
