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2型糖尿病患者并发感染与体内免疫功能改变的关系

The relationship between accompanying infection and immunologic function changes in type 2 diabetes melli-tus patients

摘要:

目的:研究2型糖尿病( T2DM)患者并发感染与体内免疫功能改变的关系。方法选取115例 T2DM 并发感染和95例非并发感染患者,102例无糖尿病史的患者作为非糖尿病感染组。所有研究对象空腹12 h 后抽取静脉血,采用糖化血红蛋白自动分析仪测定糖化血红蛋白(HbA1c)水平,流动细胞仪测定T 细胞亚群中 CD3、CD4、CD8水平,NK 细胞、B 细胞百分率,免疫散射比浊法测定免疫球蛋白(Ig)及补体(C)水平。结果T2DM 并发感染组和非并发感染组体质量指数(BMI)分别为(27.39±9.18)kg/m 2、(26.15±7.39)kg/m 2,均高于非糖尿病感染组的(24.21±5.37)kg/m 2(t =2.548、4.702,均 P <0.05);T2DM 并发感染组 IgG、IgA、IgM、C3、C4分别为(11.83±3.92)mg/mL、(3.02±0.96)mg/mL、(3.38±0.82)mg/mL、(1.70±0.38)mg/mL、(0.52±0.18)mg/mL,非并发感染组 IgG、IgA、IgM、C3、C4分别为(12.46±2.47)mg/mL、(2.63±1.37)mg/mL、(2.91±1.79)mg/mL、(1.58±0.43)mg/mL、(0.46±0.31)mg/mL,非糖尿病感染组 IgG、IgA、IgM、C3、C4分别为(13.26±3.74)mg/mL、(2.06±1.86)mg/mL、(2.49±1.01)mg/mL、(1.19±0.82)mg/mL、(0.30±0.05)mg/mL,T2DM 并发感染组和非并发感染组与非糖尿病感染组比较,体液免疫指标 IgG 水平较低,IgA、IgM、C3、C4水平较高,差异均有统计学意义(t =7.052、23.059、12.617、18.326、8.730,均 P <0.05);T2DM 并发感染组 CD4、CD8、NK、CD4/CD8、CD3分别为(37.68±8.39)%、(31.58±6.98)%、(10.76±6.49)%、(1.19±0.75)、(62.83±5.28)%,非并发感染组 CD4、CD8、NK、CD4/CD8、CD3分别为(39.23±10.28)%、(27.61±5.65)%、(14.89±7.12)%、(1.39±1.01)、(64.19±6.46)%,非糖尿病感染组 CD4、CD8、NK、CD4/CD8、CD3分别为(42.91±5.67)%、(25.17±7.25)%、(16.39±6.24)%、(1.86±0.82)、(73.65±9.10)%,T2DM 并发感染组 CD4、CD8、NK、B 细胞、CD4/CD8、CD3水平均显著降低,差异均有统计学意义(t =11.038、8.237、18.549、25.871、2.436,均 P <0.05)。结论T2DM 患者体内存在体液免疫和细胞免疫异常,T2DM 并发感染与免疫功能紊乱密切相关。

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abstracts:

Objective To investigate the relationship between accompanying infection and the change of immunologic function in type 2 diabetes mellitus ( T2DM) patients.Methods One hundred and fifteen T2DM patients with infection and 95 T2DM patients with no infection were selected,and 102 subjects with no history of dia-betes were selected as no diabetetes with infection group.The venous blood of all groups were sampled after an over-night fast of 12h.Glycosylated hemoglobin a1c(HbA1c) level was tested by glycosylated hemoglobin automatic analy-zer.The levels of T cell subsets including CD3 ,CD4 ,CD8 ,NK cell and B cell ratio were tested by flow cytometry,Ig and complement level was tested by immune nephelometry.Results The level of body mass indices(BMI) in T2DM patients with infection group[(27.39 ±9.18) kg/m2 ] and with no infection group[(26.15 ±7.39) kg/m2 ] were higher than no diabetes with infection group (24.21 ±5.37)kg/m2 (t =2.548,4.702,all P <0.05).The levels of IgG,IgA,IgM,C3 ,C4 in T2DM with infection group were (11.83 ±3.92)mg/mL,(3.02 ±0.96)mg/mL,(3.38 ± 0.82)mg/mL,(1.70 ±0.38)mg/mL,(0.52 ±0.18)mg/mL,which in T2DM with non infection group were (12.46 ± 2.47)mg/mL,(2.63 ±1.37)mg/mL,(2.91 ±1.79)mg/mL,(1.58 ±0.43)mg/mL,(0.46 ±0.31)mg/mL,which in no diabetetes with infection group were (13.26 ±3.74)mg/mL,(2.06 ±1.86)mg/mL,(2.49 ±1.01)mg/mL, (1.19 ±0.82)mg/mL,(0.30 ±0.05)mg/mL.In T2DM with non infection group and T2DM with infection group, humoral immunity index including the level of IgG was lower and IgA,IgM,C3 ,C4 levels were higher than no dia-betetes with infection group,the differences were statistically significant(t =7.052,23.059,12.617,18.326,8.730, all P <0.05).The levels of CD4 ,CD8 ,NK,CD4 /CD8 ,CD3 were (37.68 ±8.39)%,(31.58 ±6.98)%,(10.76 ± 6.49)%,(1.19 ±0.75),(62.83 ±5.28)% in T2DM with infection group,which in T2DM with non infection group were (39.23 ±10.28)%,(27.61 ±5.65)%,(14.89 ±7.12)%,(1.39 ±1.01),(64.19 ±6.46)%,which in no diabetes with infection group were (42.91 ±5.67)%,(25.17 ±7.25)%,(16.39 ±6.24)%,(1.86 ±0.82), (73.65 ±9.10)%.Cellular immunity index containing CD4 ,CD8 ,NK,CD4 /CD8 ,CD3 levels decreased more signifi-cantly than no diabetic group,T2DMI group compared with T2DM group,the levels of IgG,CD4 ,CD8 ,NK,B cell ratio, CD4 /CD8 ,CD3 decreased obviously,while the levels of IgA,IgM,C3 declined greatly,there were significant differences (t =11.038,8.237,18.549,25.871,2.436,all P <0.05).Conclusion Patients with T2DM have humoral and cellular immunity abnormalities,T2DM patients with infection is closely related with the imbalance of immunologic function.

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作者: 于冰 [1] 俞娉 [1] 李利 [1] 陈蔷 [1] 吴春丽 [2]
期刊: 《中国基层医药》2016年23卷5期 690-694页 ISTIC
栏目名称: 论 著
DOI: 10.3760/cma.j.issn.1008-6706.2016.05.013
发布时间: 2016-05-17
基金项目:
浙江省杭州市科技发展计划项目(20130733Q25) Fund program Science and Technology Development Plan of Hangzhou city in Zhejiang Province
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