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目的:探讨血小板减少性紫癜患者调节性T细胞(Treg)和辅助性T细胞17(Th17)在脾脏中的表达情况,并分析其临床意义。方法:选取46例特发性血小板减少性紫癜行脾脏切除术的患者作为观察组,同时选取20例因脾外伤而行脾脏切除的患者作为对照组,观察组根据《血液病诊断及治疗标准》中的评价标准进一步分为有效亚组(31例)和无效亚组(15例),采用免疫组织化学法进行Treg和Th17水平的测定并比较。结果:观察组患者脾脏组织中的Treg水平明显低于对照组,而Th17水平则明显高于对照组,均差异有统计学意义(均P<0.05);观察组中有效亚组患者脾脏中的Treg及Th17水平与无效亚组患者比较,均差异无统计学意义(均P>0.05)。结论:特发性血小板减少性紫癜患者脾脏组织中的Treg水平明显降低,而Th17水平则明显升高,导致两者比例失衡,可能是影响此类疾病发生、发展的一个重要因素;特发性血小板减少性紫癜患者的预后和脾脏组织中的Treg及Th17水平并无明显相关。
Objective: To investigate the expression of regulatory T cells (Tregs) and helper T cells (Th17) in spleen of patients with thrombocytopenic purpura and to analyze their clinical significance. Methods: Forty-six patients with idiopathic thrombocytopenic purpura undergoing splenectomy were selected as observation group. Twenty patients with splenectomy due to splenectomy were selected as control group. According to the criteria of diagnosis and treatment of hematological diseases, In the evaluation criteria further divided into the effective subgroup (31 cases) and the invalid subgroup (15 cases), immunohistochemistry Treg and Th17 levels were measured and compared. Results: The level of Treg in the spleen of the observation group was significantly lower than that of the control group, while the level of Th17 was significantly higher than that of the control group (all P <0.05). In the observation group, Treg and Th17 levels in patients with subgroups were not significantly different (all P> 0.05). Conclusions: Treg levels in spleen of patients with idiopathic thrombocytopenic purpura are significantly decreased, while Th17 level is significantly increased, resulting in an unbalanced ratio between them, which may be an important factor affecting the occurrence and development of such diseases; idiopathic The prognosis of patients with thrombocytopenic purpura and spleen Treg and Th17 levels were not significantly correlated.