To Explore Changes Of Lymphocyte Subsets In Peripheral Blood Of Adult Patients With Primary Immune Thrombocytopenia And Its Clinical Significance

Objective(s):Based on the analysis of peripheral blood lymphocyte subsets of adult primary immune thrombocytopenic(ITP)patients,understanding the pathogenesis of ITP,and in order to use the detection of peripheral blood lymphocyte subsets of adult primary immune thrombocytopenia providing guiding significance to the clinical features,prognosis and treatment.Methods:Collecting 54 patients of primary immune thrombocytopenia in the First Affiliated Hospital of Kunming Medical University from Jan 2016 to Feb 2017 as the study group,and 49 healthy cases were selected as control group.By testing two groups of peripheral blood lymphocyte subsets,using SPSS21.0 statistical software for statistical analysis between the two groups of lymphocyte subsets.More Than This,we will analysis the differences of lymphocyte subsets of these 54 patients further from the severity of the disease,disease status and other aspects of hierarchical difference,in order to use the detection of peripheral blood lymphocyte subsets of adult primary immune thrombocytopenia providing guiding significance to the clinical features,prognosis and treatment.Results:1.Compared with healthy control group,ITP group has the following characteristics:CD3+total T lymphocytes,CD3+CD4+T cells,CD3-CD16+CD56+NK cells,the ratio of CD4+ and CD8+T cells decrease,CD3+CD8+T cells and CD3-CD19+B lymphocytes increase(P<0.05);2.The comparisons between the new diagnosis group,the recurrent refractory group and the healthy control group were programed.Compared with healthy control group,newly diagnosed group also have the same features before we got in the first result(P<0.05).Compassed with the healthy control group,the refractory group also has same changes of subsets of the lymphocytes,but there is statistically significant in CD19+ B lymphocytes only.The differences of lymphocyte subsets between the refractory group and the newly diagnosed group were not statistically significant.3.The comparisons between the severe group,less severe ITP group and the healthy control group were programed.Compassed with the healthy control group,the severe group and less severe ITP group also have same changes of subsets of the lymphocytes(P<0.05).Compassed with less severe ITP group,the CD 19+B lymphocytes of severe ITP group decreased(P<0.05).4.Correlational analysis between the platelet count and the absolute value of CD19+ lymphocytes in 54 patients with ITP before treatment was conduct.We noticed that the CD19+B lymphocyte absolute value and platelet count before treatment was negatively correlated(r=-0.274,P=0.045).Conclusion(s):1.The ITP pathogenesis relates to complex immunological mechanisms for overall characteristic is shown as:CD3 +T lymphocyte,CD3 + CD4+T cells,CD3-CD16 + CD56 +NK cells and the ratio of CD4 + and CD8 + T cells decline,CD3 + CD8 + T cells,CD3-CD19 + B lymphocytes increase;2.CD3-CD19+B lymphocyte mediated humoral immunity may be an important mechanism for ITP patients with severe illness and repeated treatment.