原发免疫性血小板减少症患者脾脏组织调节性T细胞和Th17细胞数量的研究

OBJECTIVE: To observe the quantity of Treg cells and Th17 cells in spleen of adult primary immune thrombocytopenic purpura (ITP) patients. METHODS: 43 ITP cases with splenectomy treatment were enrolled from December 2008 to June 2016 at Union Hospital of Fujian Medical University, including 20 males and 23 females with a median age of 36 (18–76) years. The controls were thirty patients who underwent splenectomy because of pancreatic diseases or splenic impairment, including 21 males and 9 females with a median age of 47 (21–69) years. The quantity and ratio of Treg cells and Th17 cells were examined by immunohistochemistry between ITP patients and controls. RESULTS: ①The quantity of Treg cells in ITP were less than controls[(11.3±4.7) /mm(2)vs (59.0±15.0) /mm(2), t=−22.894, P<0.001], but Th17 cells were more than controls[(235.2±69.4) /mm(2)vs (181.1±23.7) /mm(2), t=13.768, P<0.001]. So the ratio of Treg/Th17 in ITP was lower than controls (0.048±0.027 vs 0.328±0.086, t=19.522, P<0.001). ②The quantity of Treg cells in cases without response after splenectomy were less than cases with response[(9.5±5.0) /mm(2)vs (11.6±4.7) /mm(2), t=2.723, P=0.010], and there is no statistical differences between the two groups about the quantity of Th17 cells and the ratio of Treg/Th17 cells[(232.3±80.8) /mm(2)vs (239.6±66.9) /mm(2), t=1.108, P=0.277; 0.040±0.024 vs 0.053±0.027, t=0.540, P=0.592]. CONCLUSION: There is a significant difference about the quantity of Treg cells and Th17 cells in spleen between ITP patients and healthy controls, and they are relevant to the response after splenectomy.