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目的:探讨Caspase-3和bcl-2在幽门螺杆菌(Helicobacter pylori HP)阳性难治性特发性血小板减少性紫癜(Id-iopathic thrombocytopenic purpura ITP)患者B淋巴细胞的表达及其意义。方法:HP阳性的难治性ITP患者给予三联抗HP治疗,并应用流式细胞仪检测患者治疗前和治疗后3个月外周血B淋巴细胞Caspase-3和bcl-2表达水平。结果:18例HP阳性的难治性ITP患者中,12例治疗有效患者Caspase-3治疗后表达率(38.3±7.2)%较治疗前(16.1±2.5)%明显升高(P<0.05),bcl-2治疗后表达率(46.4±2.3)%较治疗前(78.6±9.6)%明显下降(P<0.05),而6例治疗无效患者Caspase-3和bcl-2表达水平却无变化(P>0.05)。结论:HP感染导致慢性炎性刺激引起难治性ITP患者B淋巴细胞凋亡异常,免疫功能紊乱,血小板计数持续低下,因而清除HP感染成为难治性ITP的一个治疗手段。
Objective: To investigate the expression and significance of Caspase-3 and Bcl-2 in B lymphocytes of patients with Helicobacter pylori HP-refractory idiopathic thrombocytopenic purpura ITP. Methods: HP-positive patients with refractory ITP were treated with triple anti-HP and the expression of Caspase-3 and bcl-2 in peripheral blood B lymphocytes before and 3 months after treatment were detected by flow cytometry. Results: Among 18 HP positive patients with refractory ITP, the expression of Caspase-3 after treatment in 12 patients (38.3 ± 7.2)% was significantly higher than that before treatment (16.1 ± 2.5)% (P <0.05) The expression of bcl-2 (46.4 ± 2.3)% was significantly lower than that before treatment (78.6 ± 9.6)% (P <0.05), while the expression of bcl-2 and Caspase- > 0.05). CONCLUSIONS: HP infection leads to abnormal B lymphocyte apoptosis, immune dysfunction and low platelet count in patients with refractory ITP due to chronic inflammatory stimuli. Therefore, clearance of HP infection has become a treatment for refractory ITP.