成人原发免疫性血小板减少症患者外周血循环滤泡辅助性T细胞及IL-21的表达及意义OA
Expression and clinical significance of circulating T follicular helper cells and IL-21 in adult patients with primary immune thrombocytopenia
目的 探讨滤泡辅助性T细胞(Tfh)及IL-21在成人原发免疫性血小板减少症(ITP)患者中的表达及临床意义.方法 选取新诊断的成人ITP患者30例,根据糖皮质激素治疗后疗效评价进一步分为:完全反应组17例、有效组13例.选取同期健康体检者20例作为健康对照组.采用流式细胞术检测外周全血Tfh表达率,用ELISA法检测外周全血IL-21表达水平.结果 新诊断ITP组外周血中Tfh表达率明显高于健康对照组(P<0.05),经糖皮质激素治疗后完全反应组和有效组外周血Tfh细胞表达率均较治疗前下降(P<0.05),完全反应组治疗后外周血Tfh细胞表达率与健康对照组比较差异无统计学意义(P>0.05),有效组治疗后外周血Tfh细胞表达率仍高于健康对照组(P<0.05).新诊断的ITP组外周血中IL-21的表达水平明显高于健康对照组(P<0.05),经糖皮质激素治疗后完全反应组和有效组外周血中IL-21的表达水平均较治疗前下降(P<0.05),但仍高于健康对照组(P<0.05).相关性分析显示:新诊断ITP组、完全反应组治疗后、有效组治疗后Tfh细胞表达率与IL-21表达水平无相关性(P>0.05),Tfh细胞表达率及IL-21表达水平与各组血小板计数均无相关性(P>0.05).结论 Tfh及IL-21在成人ITP患者中的表达显著升高,提示Tfh和IL-21可能在ITP的发病机制中发挥重要作用,且二者的表达水平可能反映ITP治疗效果.
Objective To investigate the expression and clinical significance of circulating follicular helper T cells(Tfh)and interleu-kin-21(IL-21)in adult patients with primary immune thrombocytopenia(ITP).Methods A total of 30 newly diagnosed adult ITP pa-tients were enrolled in this study,and stratified into complete response(CR)group(n=17)and response(R)group(n=13)based on the therapeutic response to glucocorticoids.Twenty healthy individuals matched during the same period served as control group.The expression rate of circulating Tfh cells was measured by flow cytometry,and the expression level of IL-21 was detected by enzyme-linked immunosorbent assay(ELISA).Results The expression rate of Tfh cells and the expression level of IL-21 in peripheral blood were significantly higher in newly diagnosed ITP group than those in control group(P<0.05).After glucocorticoid treatment,the expression rate of peripheral blood Tfh cells decreased significantly in both CR group and R group(P<0.05).There was no significant difference in the expression rate of peripheral blood Tfh cells between CR group after treatment and control group(P>0.05).After glucocorticoid treatment,the expression rate of peripheral blood Tfh cells in R group was higher than that in control group(P<0.05).The expression of IL-21 in peripheral blood in newly diagnosed ITP group was significantly higher than that in control group(P<0.05).After glucocorticoid treatment,the expression levels of IL-21 in peripheral blood decreased significantly in both CR group and R group(P<0.05),however,they were still significantly higher than those in control group(P<0.05).There was no significant correlation between Tfh cell expression rate and IL-21 level in newly diagnosed ITP group,CR group after treatment,or R group after treatment(P>0.05).Furthermore,Tfh cell expression rate and IL-21 expression level showed no significant correlation with the platelet count in newly diagnosed ITP group,CR group after treatment,or R group after treatment(P>0.05).Conclusion The expressions of Tfh cells and IL-21 are significantly elevated in adult ITP patients,which suggests their potential role in the pathogenesis of this disease,and their expression levels may further imply the therapeutic efficacy.
王超;邹艳慧
内蒙古自治区人民医院干部保健中心,呼和浩特 010010内蒙古自治区人民医院干部保健中心,呼和浩特 010010
医药卫生
原发免疫性血小板减少症滤泡辅助性T细胞白细胞介素-21糖皮质激素外周血淋巴细胞
primary immune thrombocytopeniaT follicular helper cellsIL-21glucocorticoidperipheral bloodlym-phocyte
《山西医科大学学报》 2026 (2)
201-206,6
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