Objective: To observe the quantity of Treg cells and Th17 cells in spleen of adult primary immune thrombocytopenic purpura (ITP) patients. Methods: 43 ITP cases with splenectomy treatment were enrolled from December 2008 to June 2016 at Union Hospital of Fujian Medical University, including 20 males and 23 females with a median age of 36 (18-76) years. The controls were thirty patients who underwent splenectomy because of pancreatic diseases or splenic impairment, including 21 males and 9 females with a median age of 47 (21-69) years. The quantity and ratio of Treg cells and Th17 cells were examined by immunohistochemistry between ITP patients and controls. Results: ①The quantity of Treg cells in ITP were less than controls[ (11.3±4.7) /mm(2) vs (59.0±15.0) /mm(2), t=-22.894, P<0.001], but Th17 cells were more than controls[ (235.2±69.4) /mm(2) vs (181.1±23.7) /mm(2), t=13.768, P<0.001]. So the ratio of Treg/Th17 in ITP was lower than controls (0.048±0.027 vs 0.328±0.086, t=19.522, P<0.001) . ② The quantity of Treg cells in cases without response after splenectomy were less than cases with response[ (9.5±5.0) /mm(2) vs (11.6±4.7) /mm(2), t=2.723, P=0.010], and there is no statistical differences between the two groups about the quantity of Th17 cells and the ratio of Treg/Th17 cells[ (232.3±80.8) /mm(2) vs (239.6±66.9) /mm(2), t=1.108, P=0.277; 0.040±0.024 vs 0.053±0.027, t=0.540, P=0.592]. Conclusions: There is a significant difference about the quantity of Treg cells and Th17 cells in spleen between ITP patients and healthy controls, and they are relevant to the response after splenectomy.
目的：观察成人原发免疫性血小板减少症（ITP）患者脾脏组织中调节性T细胞（Treg细胞）和Th17细胞的变化。方法： 2008年12月1日至2016年6月30日期间在福建医科大学附属协和医院接受脾切除术治疗的43例ITP患者纳入研究，男20例，女23例，中位年龄36（18~76）岁。以30例因胰腺疾病或脾外伤接受脾切除术的患者作为对照组，男21例，女9例，中位年龄47（21~69）岁。运用免疫组化技术对脾脏组织中Treg细胞和Th17细胞数量进行观察，计算Treg细胞/Th17细胞比值，分析ITP组与对照组以及脾切除有效与无效ITP患者脾脏组织中Treg、Th17细胞数量及Treg/Th17细胞比值差异。结果： ①ITP组脾脏组织中Treg细胞少于对照组[（11.3±4.7）个/mm(2)对（59.0±15.0）个/mm(2)，t=-22.894，P<0.001]，Th17细胞多于对照组[（235.2±69.4）个/mm(2)对（181.1±23.7）个/mm(2)，t=13.768，P<0.001]，Treg/Th17细胞比值低于对照组（0.048±0.027对0.328±0.086，t=19.522，P<0.001）。②脾切除术无效ITP患者脾脏组织中Treg细胞少于有效患者[（9.5±5.0）个/mm(2)对（11.6±4.7）个/mm(2)，t=2.723，P=0.010]，Th17细胞计数、Treg/Th17细胞比值差异无统计学意义[（232.3±80.8）个/mm(2)对（239.6±66.9）个/mm(2)，t=1.108，P=0.277；0.040±0.024对0.053±0.027，t=0.540，P=0.592]。结论：成人ITP患者脾脏组织中Treg、Th17细胞数量有显著改变，可能与脾切除术疗效有一定关联。.
Keywords: Splenectomy; T-Lymphocytes, regulatory; Th17 cells; Thrombocytopenia.