| BackgroundImmune thrombocytopenia?ITP?is a benign and self limiting hemorrhagic condition,which is one of the most common hemorrhagic diseases in children.The pathogenesis of the disease involves many aspects of humoral immunity,cellular immunity and gene polymorphism,but specific disease mechanisms have not been fully elucidated.With further research,it has been found that the balance between T lymphocytes and cytokines plays an important role in the occurrence and development of ITP.However,there are still some controversies about the research of T lymphocyte dysfunction in ITP children at home and abroad,and the specific relationship between cytokines and ITP is not clear.ObjectiveWe will detect the T lymphocyte associated cytokine levels in the peripheral blood before and after treatment of newly diagnosed ITP patients by flow cytometry?Cytometric bead microspheres array technology array,CBA?and further explore the relationship between cytokines and ITP.Methods1.Subjects According to the recommendations for Diagnosis and treatment of primary immune thrombocytopenia in children[1]formulated by hematology group of pediatrics branch of Chinese medical association in 2013,the study collected 40 cases of newly diagnosed ITP children from July 2016 to October 2017 in First Affiliated Hospital of Xinxiang Medical College as the experimental group,31 cases of healthy outpatient children in the same period as control group.There was no statistically significant difference of age and sex between the two group.2.T lymphocyte related cytokine levels were detected.2 ml of peripheral venous blood of subjects was collected aseptically.The levels of seven cytokines?IL-2,IL-4,IL-6,IL-10,TNF,IFN-?,IL-17A?in serum were detected by CBA technique and Th1/Th2/Th17cytokines CBA assay kit.3.Statistical processing SPSS22.0 software was used for statistical analysis.The quantitative data were expressed by mean±standard deviation?X±S?.Before the statistical analysis,normality and homogeneity of variance were tested in each group of data.Two samples were compared with t test.Chi-square test was used to count data,and correlation analysis was done by Pearson linear correlation analysis.The difference in P<0.05 was statistically significant.Results1.Comparison of cytokine levels between the experimental group and the control groupBefore treatment,IL-2,TNF,IFN-?,IL-6,IL-17A level?6.51±2.25pg/ml,3.67±3.60pg/ml,4.48±5.61pg/ml,6.94±5.26pg/ml,6.31±5.28pg/ml?of the experimental group higher than that of the control group?5.19±0.37pg/ml,1.93±0.29pg/ml,2.04±0.33pg/ml,2.08±0.49pg/ml,1.69±0.11pg/ml?the level of IL-4 and IL-10?1.11±1.15pg/ml,2.48±1.56pg/ml?is lower than that of the control group?3.09±0.27pg/ml,3.34±0.92pg/ml?,the differences were statistically significant?t=3.655,3.037,2.744,5.810,5.537,10.506,2.906,P=0.001,0.004,0.009,0.000,0.000,0.000,0.005?.2.Comparison of cytokines before and after treatment of the experimental groupFor the experimental group,IL-2,TNF,IFN-?,IL-6,IL-17A level?5.09±1.00pg/ml,2.11±1.93pg/ml,2.22±1.86pg/ml,2.26±2.69pg/ml,2.16±2.07pg/ml?decreased after treatment,while the IL-4 and IL-10 level?2.90±1.13pg/ml,3.94±2.41pg/ml?is higher than that before treatment,the differences were statistically significant?t=4.447,3.044,2.808,6.544,5.711,16.568,3.393,P=0.000,0.004,0.008,0.000,0.000,0.000,0.002?.3.Comparison of the cytokine in the experimental group and the control group IL-2,TNF,IFN-?,IL-6,IL-4,IL-10,IL-17A levels of the experimental group after treatment compared with the control group showed no significant differences,the differences ere not statistically significant?t=0.587,0.558,0.584,0.420,1.029,1.440,1.424,P=0.560,0.580,0.563,0.677,0.309,0.156,0.162?.4.Correlation analysis of 7 cytokines and plateletsThe correlation analysis of level changes between IL-2,TNF,IFN-?,IL-6,IL-4,IL-10,IL-17A level and platelet level before and after treatment,no significant correlation?r=-0.13,0.20,0.09,-0.05,-0.11,-0.15,-0.03,P=0.43,0.21,0.59,0.74,0.49,0.37,0.86?.5.Analysis of the correlation between 7 cytokines in the experimental groupThe correlation analysis among IL-2,IL-4,IL-6,IL-10,TNF,IFN-?and IL-17A showed that IL-2 was positively correlated with IL-6?r=0.38,P=0.00?,and there was a positive correlation between IL-6 and IFN-?,and there was a positive correlation between IL-2 and IFN-?.Conclusions1.There are various cytokines disorder in newly diagnosed ITP children,which suggests that the imbalance of the three cell subsets of Thl,Th2 and Thl7 is involved in the pathogenesis of ITP,and shows the advantages of Th1 and Th17.2.By measuring the levels of T lymphocyte related cytokines in peripheral blood of children with ITP before and after treatment,the state of disease can be preliminarily determined. |
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