Quantity Change and Its Clinical Significance of Immunological Cells in Clildren with Idiopathic Thrombocytopenic Purpura

Objective To study the change and its clinical significance of T and B lymphocytes in children with idio- pathic thrombocytopenic purpura (ITP).Methods T and B lymphocytes were detected by flow cytometry in 38 children with ITP (18 cases of acute ITP and 20 cases of chronic ITP) and 30 normal controls.Results The children with ITP had abnor- malities in T-lymphocyte subsets.The number of CD4 in chronic ITP group was significandy lower than that in control and acute ITP group (t=7.08,5.51,P0.001),and the number of CD8 was significantly higher than that in control and acute ITP group (t=4.11,4.93,P0.001).All patients had the abnormalities of B-lymphocyte,the numbers of CD19 and CD3~-/ HLA-DR~+ cells in patients with acute or chronic ITP were all significantly higher than that in control group (t=4.37,7.25, 8.08,7.22,all P0.001),the number of CD19 in chronic ITP group was significantly higher than that in acute ITP group (t=2.18,P0.05).The numbers of CD19 and CD3~-/HLA-DR~+ showed no significant differences in ITP patients with nor- real or abnormal ratio of CD4 to CD8.(t=1.99,0.64,1.63,1.44,all P0.05).The number of CD8 in ITP patients whose platelet counts had returned to normal level after therapy with corticoid and adequate dosage of IVIg was significantly lower than that of patients before therapy (t=3.68,P0.01).After 8 weeks' therapy,both T-lymphocyte and B-lymphocyte counts had returned to normal levels.Conclusion Disturbances of T-lymphocyte and B-lymphocyte substets were involved in gen- eration and development of ITP.Elevation of B-lymphocyte counts was more sensitive in reflecting immunological function.The abnormalities of B-lymphocyte and T-lymphocyte subsets still existed for some time even when the platelet count had returned to normal level after treatment in patients with ITP.