临床儿科杂志 ›› 2022, Vol. 40 ›› Issue (2): 95-100.doi: 10.12372/jcp.2022.21e1233

• 血液/肿瘤疾病专栏 • 上一篇    下一篇

趋化因子CCL3、CCL4在儿童免疫性血小板减少症中的表达及临床意义

陈东平, 罗茜, 黄佩, 郭义敏, 吴柳松, 何志旭, 陈艳()   

  1. 遵义医科大学附属医院小儿内科 贵州省儿童医院 遵义医科大学组织损伤修复与再生医学省部共建协同创新中心(贵州遵义 563003)
  • 收稿日期:2021-08-25 出版日期:2022-02-15 发布日期:2022-02-11
  • 通讯作者: 陈艳 E-mail:cyz600@163.com
  • 基金资助:
    遵义医科大学组织损伤修复与再生医学省部共建协同创新中心项目(教科技厅函[2020]39号);贵州省科技计划项目(黔科合平台人才-CXTD〔2021〕010)

Expression and clinical essential of chemokines CCL3 and CCL4 in children with ITP

CHEN Dongping, LUO Xi, HUANG Pei, GUO Yimin, WU Liusong, HE Zhixu, CHEN Yan()   

  1. Department of Pediatric Medicine, Affiliated Hospital of Zunyi Medical University, Guizhou Children’s Hospital, The Collaborative Innovation Center of Tissue Damage Repair and Regeneration Medicine of Zunyi Medical University, Zunyi 563003, Guizhou, China
  • Received:2021-08-25 Online:2022-02-15 Published:2022-02-11
  • Contact: CHEN Yan E-mail:cyz600@163.com

摘要:

目的 探讨趋化因子CCL3、CCL4在儿童免疫性血小板减少症(ITP)中的表达及其临床意义。方法 选择2019年12月至2020年4月住院确诊的ITP患儿为研究对象,根据病程分为新诊断组(n=37,病程≤3个月)和非新诊断组(n=27,病程>3个月),根据采集标本时机(初诊及入院治疗7天时)分为治疗前组(n=29)和治疗后组(n=35);并以门诊健康体检儿童为对照组,比较不同组间CCL3、CCL4表达,血小板(PCT)相关指标等。结果 共纳入64例ITP患儿,男42例、女22例,中位年龄5.1(3.0~8.0)岁;健康对照组19例,男12例、女7例,中位年龄为4.2(2.8~6.0)岁。治疗前组、治疗后组与对照组之间PLT计数、PLT体积(MPV)、PLT比率(P-LCR)、PLT分布宽度(PDW)、PLT比积(PCT)以及IgG水平的差异均有统计学意义(P<0.05);治疗前组的PLT计数和PCT较低,MPV、P-LCR、PDW以及IgG较高。新诊断组、非新诊断组CCL3、CCL4浓度均高于对照组,差异有统计学意义(P<0.05)。治疗前组、治疗后组CCL3和CCL4浓度均高于对照组,治疗后组CCL3和 CCL4浓度均低于治疗前组,差异有统计学意义(P<0.05)。ITP不同出血评分组之间CCL3、CCL4表达差异有统计学意义(P<0.05);随着出血评分增加,CCL3、CCL4表达水平逐渐增加。治疗无效组的CCL3、CCL4表达水平高于完全反应组和反应组,而反应组的CCL3、CCL4表达均低于完全反应组,差异有统计学意义(P<0.05)。结论 CCL3、CCL4可作为评估儿童ITP病情危重程度及治疗反应的分子标志物。

关键词: 免疫性血小板减少症, 趋化因子CCL3, 趋化因子CCL4, 儿童

Abstract:

Objective To investigate expression and clinical significance of chemokines CCL3 and CCL4 in childhood immune thrombocytopenia (ITP). Methods Children with ITP diagnosed in Affiliated Hospital of Zunyi Medical University from December 2019 to April 2020 were selected as study subjects, and were divided into newly diagnosed group (n=37, disease duration ≤3 months) and non-newly diagnosed group (n=27, disease duration >3 months) according to the disease duration, and into pre-treatment group (n=29) and post-treatment group (n=35) according to the timing of specimen collection (at the first diagnosis and 7th day of hospital admission); and healthy children with outpatient health examination were used as the control group, and the expression of CCL3 and CCL4 and platelet-related indexes were compared between different groups. Results A total of 64 children with ITP, 42 males and 22 females, with a median age of 5.1 (3.0-8.0) years, and 19 healthy controls, 12 males and 7 females, with a median age of 4.2 (2.8-6.0) years, were included. The differences in PLT counts, MPV, P-LCR, PDW, PCT, and IgG levels between the pre-treatment group, post-treatment group, and control group were statistically significant (P<0.05); PLT counts and PCT were lower and MPV, P-LCR, PDW, and IgG were higher in the pre-treatment group. CCL3 and CCL4 concentrations were higher in the newly diagnosed and non-newly diagnosed groups than in the control group, with statistically significant differences (P<0.05). The CCL3 and CCL4 concentrations were higher in the pre-treatment and post-treatment groups than in the control group, and the CCL3 and CCL4 concentrations were lower in the post-treatment group than in the pre-treatment group, with statistically significant differences (P<0.05). The differences in CCL3 and CCL4 expression between different bleeding score groups of ITP were statistically significant (P<0.05). The expression levels of CCL3 and CCL4 increased gradually with the increase of bleeding score. The CCL3 and CCL4 expression levels in the treatment ineffective group were higher than those in the complete response group and the response group, while the CCL3 and CCL4 expressions in the response group were lower than those in the complete response group, and the differences were statistically significant (P<0.05). Conclusion CCL3 and CCL4 can be used as children's molecular markers of ITP to assess its severity and response to treatment.

Key words: immune thrombocytopenia, chemokine CCL3, chemokine CCL4, child