摘要
研究目的
特发性血小板减少性紫癜(idiopathic thrombocytopenic purpura，ITP)是一种常见的自身免疫性疾病，临床上按照病程是否超过6个月分为急性型(AITP)和慢性型(CITP)两种，儿童时期以AITP多见，其发病机制至今尚未完全阐明。近年来研究表明ITP患者体内激活的淋巴细胞凋亡不足可能在疾病的发生和发展中发挥重要作用。
细胞凋亡是细胞按既定程序主动结束生命的一种死亡形式，它主要是由死亡受体信号(主要是Fas／FasL系统)调控的细胞外凋亡途径和由Bcl-2基因家族调控的细胞内凋亡途径调节的。干预淋巴细胞凋亡的调节过程可以通过诱导淋巴细胞凋亡而起到治疗作用，因而针对ITP时凋亡调控系统各环节的研究有重要意义。本实验旨在探讨AITP患儿外周血淋巴细胞凋亡率与凋亡蛋白Bcl-2、Bax、Bcl-2／Bax比值及其与血小板计数的关系，以进一步了解ITP的发病机制，为临床治疗提供理论依据。
材料与方法
1．对象：选择郑州大学第一附属医院2005年3月～8月儿科门诊及病房的AITP患儿25例，其中男17例，女8例，年龄1.2岁～11岁(平均4.3岁)，诊断均符合急性特发性血小板减少性紫癜诊断标准。另选择健康体检儿童15例作为对照组，其中男8例，女7例，年龄3～10岁(平均5.6岁)。
Objective Idiopathic thrombocytopenic purpura (ITP) is the most common hemorrhagic disease in children. According to the course of disease it is divided into two types: AITP and CITP, AITP is more common in children. The origin of the disease is to be elucidated. Recently it was reported that the deficient apoptosis of activated lymphocytes in the peripheral blood might play an important role in the development of the disease.
Apoptosis is a physiologic or pathological form of cell death that follows activation of either an intrinsic or extrinsic pathway. The intrinsic cell death pathway is controlled by bcl-2 family members. The extrinsic pathway is controlled by death receptor signaling. These two pathways work together to regulate lymphocytes development and function. Intervention in the controlling of lymphocytes apoptosis might play a part in therapy of ITP. Studies of the controlling of lymphocytes apoptosis would be meaningful.
The purpose of this study was to investigate the apoptosis rate of lymphocytes, the positive rate of Bcl-2 protein and Bax protein in lymphocytes of AITP children, and to analyze the relationship between the apoptosis rate of lymphocytes and platelet counts, the relationship between the apoptosis rate of lymphocytes and the positive rate of Bcl-2 protein, the relationship between the apoptosis rate and the positive rate of Bax protein, the relationship between the apoptosis rate of lymphocytes and the Bcl-2/Bax ratio.
引文
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