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1、31例腹腔镜脾切除术治疗ITP前后T淋巴细胞亚群检测分析马利锋王晨宇李涛张立超刘国超王建龙康建省(通讯作者)［摘要］目的：测定特发性血小板减少性紫癜(ITP)患者腹腔镜脾切除术前后外周血T淋巴细胞亚群的变化，并分析其临床意义。方法：通过采集31例患者手术前后静脉血，采用流式细胞术检测外周血CD3+、CD4+、CD3/CD4、CD3/CD8及CD3CD4/CD3CD8比值，同时测定血常规，比较T淋巴细胞亚群手术前后变化及与血小板变化的相关性。结果：31例因ITP行手术治疗患者前后比较CD3+、CD4+、CD3/CD4、CD3/CD8及CD3CD4/C
2、D3CD8测定值差异均有统计学意义(P<0.05),且与术后血小板变化呈一定相关性。结论：ITP患者存在T淋巴细胞亚群失衡，脾切除术可改善ITP患者T淋巴细胞亚群的失衡，且可能作为一个了解患者预后的参考指标。［关键词］特发性血小板减少性紫癜腹腔镜脾切除术T淋巴细胞亚群D0l:10.3760/cma.j.issn.0376-2491.2014.44.029作者单位：马利锋，李涛，张立超，刘国超，王建龙，康建省(通讯作者)：050005河北石家庄，河北医科大学第二医院王晨宇：075000河北张家口，河北北方学院附属第一医院TheChangesofT-l
3、ymphocyteSubsetamong31PatientswithIdiopathicThrombocytopenicPurpurabeforeandafterLaparoscopicSplenectomyMaLifeng,WangChenyu,LiTao,ZhangLichao,LiuGuochao,WangJianlong,KangJianshengAbstract:ObjectiveToexplorethechangesofperipheralbloodT-lymphocytesubsetamongpatientswithidiopathi
4、cthrombocytopenicpurpura(ITP)beforeandafterlaparoscopicsplenectomy,andanalyzeitsclinicalsignificance.MethodThevenousbloodofthe31patientsbeforeandafteroperationwereacquiredtodetecttheperipheralblood’sCD3+,CD4+,CD3/CD4,CD3/CD8andCD3CD4/CD3CD8ratiothroughthemethodofflowcyto
5、metrydetection.Meanwhile,patients’routinebloodtestswerealsoconductedtostudythecorrelationbetweenT-lymphocytesubsetschangesbeforeandafteroperationandthechangeofplatelet.ResultThedifferencesofCD3+,CD4+,CD3/CD4,CD3/CD8andCD3CD4/CD3CD8inthe31patientsbeforeandaftertheoperatio
6、nbyidiopathicthrombocytopenicpurpurawereofstatisticallysignificant(P<O.O5)zandthechangesofplateletwerealsoassociatedwiththeoperation.ConclusionITPpatientshavetheimbalanceofT-lymphocytesubsets.SplenectomycanimprovetheT-lymphocytesubsetsimbalanceinpatientswithITP,andmayservea
7、sareferencetotheprognosisofsuchpatients.Keywords:idiopathicthrombocytopenicpurpura;laparoscope;splenectomy;T-lymphocytesubsets特发性血小板减少性紫癜(idiopathicthrombocytopenicpurpura,ITP),也叫自身免疫性血小板减少性紫癜(idiopathicautoimmunethrombocytopenicpurpura,ATTP),是临床上最常见的一种血小板减少性疾病。主要由于自身抗体与血小板结合，
8、引起血小板生存期缩短。ITP的人群发病率估计约为1/10000,女性:男性比例约2-3:lolTP患者除冇体液免疫异常外，
