摘要目的：通过检测新诊断免疫性血小板减少症（ITP）患儿 B 淋巴细胞特异单克隆鼠白血病病毒整合位点基因-1（Bmi-1）及辅助性 T 淋巴细胞相关因子γ干扰素（IFN-γ）、白细胞介素4（IL-4）mRNA 的表达变化，分析探讨 Bmi-1及 Th1／Th2细胞比例在新诊断 ITP 患儿中的变化及意义。方法试验组36例 ITP 患儿均来源于新乡医学院第一附属医院儿科2013年4至12月住院和门诊患儿，同期小儿外科择期手术患儿26例作为对照组，采用反转录-聚合酶链反应（RT-PCR）方法检测外周血淋巴细胞中 Bmi-1、TFN-γ、IL-4 mRNA 的表达；并采用 t 检验和直线相关分析进行分析比较。结果1．试验组外周血淋巴细胞中 Bmi-1 mRNA 为2．63±0．54，对照组 Bmi-1 mRNA 为3．91±0．92，试验组明显低于对照组（P ＜0．001）；试验组 IFN-γmRNA 为3．84±0．43，对照组 IFN-γmRNA 为2．88±0．57，试验组明显高于对照组（P ＜0．001）；试验组 IL-4 mRNA 为1．44±0．39，对照组 IL-4 mRNA 为1．87±0．34，试验组明显低于对照组（P ＜0．001）。2．试验组外周血淋巴细胞中 IFN-γmRNA 表达与 IL-4 mRNA 表达呈负相关（r ＝－0．667，P ＜0．001），IL-4 mRNA 表达与 Bmi-1 mRNA 表达呈正相关（r ＝0．776，P ＜0．001），IFN-γmRNA 表达与 Bmi-1 mRNA 表达无相关性（r ＝－0．206，P ＞0．05）。结论Bmi-1可能通过调节 Th 细胞参与 ITP 发病；ITP 患儿存在 Th 细胞功能紊乱、Th1／Th2比例失调，可能是 Th1优势。

abstractsObjective To analyze the functional changes and the clinical significance of B cell specific mono-clonal murine leukemia virus integration site -1 (Bmi -1 )and Th1 /Th2 cells in children with newly diagnosed im-mune thrombocytopenia(ITP)by testing the mRNA expressions of Bmi -1,helper T cell -related cytokine interferon (IFN)-γand interleukin(IL)-4 in children with newly diagnosed ITP.Methods Thirty -six cases of patients with newly diagnosed ITP in the experimental group came from the inpatient and outpatient children admitted to the Depart-ment of Pediatrics of the First Affiliated Hospital of Xinxiang Medical University from April to December 201 3.In the control group,26 cases of children requiring selective operation were admitted to the Department of Pediatric Surgery during the same period.The mRNA expressions of Bmi -1,IFN -γand IL -4 in the peripheral blood lymphocytes were detected by means of the reverse transcription -polymerase chain reaction(RT -PCR)method,and were analyzed and compared by t test and linear correlation analysis.Results (1 )The mRNA expressions of Bmi -1,IFN -γand IL -4 in peripheral blood lymphocytes in the experimental group were 2.63 ±0.54,3.84 ±0.43 and 1 .44 ±0.39,respec-tively;while the mRNA expressions of Bmi -1,IFN -γand IL -4 in the peripheral blood lymphocytes in the control group were 3.91 ±0.92,2.88 ±0.57 and 1 .87 ±0.34,respectively.The levels of IFN -γof the experimental group were significantly higher than those of the control group (P <0.001 )and the levels of Bmi -1 and IL -4 in the experi-mental group were significantly lower than those in the control group (all P <0.001 ).(2)The mRNA expressions be-tween IFN -γand IL -4 in the peripheral blood lymphocytes in the experimental group were in negative correlation (r =-0.667,P <0.001 ).The mRNA expressions between IL -4 and Bmi -1 in the same group were in a positive correlation (r =0.776,P <0.001 ).There were no correlation in the mRNA expressions between IFN -γand Bmi -1 (r =-0.206,P >0.05).Conclusions Bmi -1 may be involved in the pathogenesis of ITP by regulating Th cell, and Th cell dysfunction may occur in the children with ITP,and the disproportion between Th1 and Th2 may be due to the advantages of Th1 .