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目的探讨免疫性血小板减少症(immune thrombocytopenia,ITP)患者外周血B细胞、成熟B细胞、滤泡辅助性T细胞及树突状细胞亚群的变化,及其相互关系及Tfh细胞在ITP发病中的作用。方法采用流式细胞术检测35例初治ITP患者及30例正常人外周血B细胞及成熟B细胞比例、Tfh细胞数量及树突细胞亚群。结果 ITP患者外周血CD19+B细胞及成熟B细胞比例分别为(13.49±9.05)%和(81.96±11.99)%,均高于对照组[(9.12±4.60)%和(75.42±12.86)%,P<0.05]。ITP患者Tfh细胞(CD4+CXCR5+ICOS+PD-1+)比例为(4.27±3.88)%,明显高于对照组(1.02±0.54)%,差异有统计学意义(P<0.01)。ITP患者浆细胞树突细胞比例为(2.06±1.65)%,明显低于对照组(5.07±3.48)%,差异有统计学意义(P<0.01)。结论 ITP患者存在Tfh细胞数量异常,可能导致B细胞比例升高,在ITP的发病机制中起重要作用。
Objective To investigate the changes of peripheral blood B cells, mature B cells, follicular helper T cells and dendritic cell subsets in patients with immune thrombocytopenia (ITP) and their relationship and the relationship between Tfh cells and ITP Role. Methods Flow cytometry was used to detect the percentage of B cells, mature B cells, Tfh cells and dendritic cell subsets in peripheral blood of 35 newly diagnosed ITP patients and 30 healthy controls. Results The percentage of CD19 + B cells and mature B cells in peripheral blood of ITP patients were (13.49 ± 9.05)% and (81.96 ± 11.99)%, respectively, which were significantly higher than that of the control group [(9.12 ± 4.60)% vs (75.42 ± 12.86% P <0.05]. The proportion of Tfh cells (CD4 + CXCR5 + ICOS + PD-1 +) in ITP patients was (4.27 ± 3.88)%, which was significantly higher than that in control group (1.02 ± 0.54)%, the difference was statistically significant (P <0.01). The proportion of plasma cell dendritic cells in ITP patients was (2.06 ± 1.65)%, which was significantly lower than that in control group (5.07 ± 3.48)%, the difference was statistically significant (P <0.01). Conclusions The number of Tfh cells in patients with ITP is abnormal, which may lead to the increase of the proportion of B cells and play an important role in the pathogenesis of ITP.