中文摘要：

目的 探讨原发免疫性血小板减少症（ITP）患者外周血CD14＋CD16＋单核细胞数量的变化及其临床意义。方法采用流式细胞术检测ITP患者治疗前组（n=31）、治疗后缓解组（n=25）和健康对照组（n=30）受检者外周血CD14＋CD16＋单核细胞数量，采用ELISA方法检测血清TNF-a、IL-12和IL-10浓度，使用SysmexXE-2100做血小板计数。结果CD14＋CD16＋单核细胞（％）：ITP患者治疗前组、治疗后缓解组与健康对照组分别为6．49±0．87销2．60±0．75协1．10±0．58（P〈0．01）；TNF-a，IL-12和IL-10在3组之间的表达差异均有统计学意义（P〈0．01），ITP患者治疗前组CD14＋CD16＋单核细胞比例与血小板计数，TNF-d和IL-10浓度具有相关（r=-0．623；r=0．492；r=-0．661，P〈0．05）。结论CD14＋CD16＋单核细胞数量在111P患者中明显增高，并且与细胞因子的异常表达相关，提示CD14＋CD16＋单核细胞可能通过调控细胞因子的表达参与疾病的发生发展，为未来临床判断I＋rP的治疗效果提供了新的潜在标志物。

英文摘要：

Objective To determine the expression of CD14 ＋ CD16 ＋ monocyte in peripheral blood from patients with primary immune thrombocytopenia （ITP） and explore its clinical significance. Methods Peripheral biood samples from ITP patients before treatment （ n = 31 ）, patients who achieved remissions after treatment （ n = 25） and healthy controls （ n = 30）were obtained. Expression of CD14＋ CD16＋ monocytes was determined using flow cytometry. The level of cytokines （TNF- a,IL-12,IL-10） was detected by ELISA. Platelet count was determined by Sysmex XE-2100. Results The percentages of CD14＋ CD16＋ monocyte expressions in the three groups were 6.49± 0. 87, 2. 60 ± 0.75,1.10±0.58, respectively. The expression of TNF-a, IL-12 and IL-10 between the three groups suggested statistically significant difference （P 〈 0. 001 ）. Moreover, CD14＋ CD16＋ monocyte expression was positively correlated with platelet count and serum TNF-a level（ r = - 0. 623 ; r = 0. 492 ,P 〈 0. 05 ）, and negatively correlated with serum IL-10 level（r = - 0. 661, P 〈 0. 01 ）. Conclusion The number of monocytes in CD14 ＋ CD16＋ is significantly higher in ITP patients and correlates with the abnormal expression of eytokines, suggesting that CD14＋ CD16 ＋ monocytes may be involved in the development of the disease by regulating cytokine expression, which might provide a new potential marker for clinical judgment of ITP in the future.