【摘要】 目的研究ITP时脾脏的病理形态及免疫组化特点。方法应用光镜观察52例ITP脾脏的形态特征;用免疫组化S-P法检测CD3、CD4、CD8、CD20、CD41、CD43、CD45Ro、CD68、P53和PCNA在ITP脾脏组织中的表达情况。结果本组男女之比为0.18∶1,男性平均年龄26.75岁,女性平均年龄34.18岁。急性型之脾脏大小与质量正常;慢性型脾脏呈轻度肿大。主要组织学改变是白髓滤泡反应性增生,生发中心扩大,滤泡周边带增宽,中央动脉壁增厚、纤维化,微血管增生。CD8+细胞多于CD4+T淋巴细胞;含血小板抗原的CD41+和CD43+淋巴细胞主要分布于生发中心,PCNA+淋巴细胞在红、白髓中均呈弥漫而密集分布;CD68+组织细胞数量较正常增多,T、B淋巴细胞和组织细胞呈增殖现象。结论T细胞亚群与免疫细胞的平衡紊乱是ITP细胞免疫功能异常导致血小板破坏的重要因素。更多还原

【Abstract】 Objective It is to study the pathomorphogical and immunochemical features of the spleen in idiopathic thrombocytopenic purpura(ITP).Methods The morphologic characteristics of the spleen in 52 cases of ITP were observed with light microscopy.The expression of CD3,CD4,CD8,CD20,CD41,CD43,CD45Ro,CD68,P53 and PCNA protein in the spleen were detected with S-P immunohistochemical method.Results The ratio of the male with female was 0.18∶1.The average age of the males was 26.75 years old. The average age of the females was 34.18 years old.Acute ITP showed no splenomegaly.The splenomegaly of the chronic ITP was low-grade.The main pathologic change was reactive follicular hyperplasia of the white pulp,germinal central enlarging and broaden of the marginal zone.The walls of middle arteries were thick and fibrosis.The CD8+ lymphocytes were more than CD4+ lymphocytes.The CD41 and CD43 lymphocytes which contained platelet antigen were mainly distributed in the germinal center.PCNA+ lymphocytes were distributed suffusion and densely in red pulp and white pulp.The number of histocytes was more than normal.The T and B cells and histocytes were showed proliferation phenomenon.Conclusion The balance derangement of T cell subpopulation and immunocyte is the important factor of ITP cellular immune function abnormality induced platelet demolition.更多还原