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12h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（HbAlc）水平，流动细胞仪测定T细胞亚群中CD，、CD。、CD。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／m2、（26．15±7．39）kg／m2，均高于非糖尿病感染组的（24．21±5．37）kg／m2（t=2．548、4．702，均P〈0．05）；T2DM并发感染组IgC、IgA、IgM、c3、C4分另0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／m2，非并发感染组IgG、IgA、IgM、C3、C4分别为（12．46±2．47）mg／mC、（2．63±1．37）mg／mL、（2．91±1．79）mg／mL、（1．58±0．43）me／mL、（0．46±0．31）mg／mL，非糖尿病感染组IgC、IgA、IgM、c3、c4分另9为（13．26士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IgC水平较低，IgA、IgM、C3、c。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CD3、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、CD，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。
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 subjectswith 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 alc（HbAlc） level was tested by glyeosylated hemoglobin automatic analy- zer. The levels of T c.ell 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. Resdts 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） rag/mE, （ 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 lgA, 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,CDJCD8 ,CDa 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, CDs, NK, CD4/CDa, CDa levels decreased more signifi- cantly than no diabetic group, T2DMI group compared with T2DM group, the levels of IgG, CD4, CDs, NK, B cell ratio, CDJCDs , CD3 decreased obviously, while the levels of IgA, IgM, C4 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.
出处
《中国基层医药》
CAS
2016年第5期690-694,共5页
Chinese Journal of Primary Medicine and Pharmacy
基金
基金项目：浙江省杭州市科技发展计划项目（20130733Q25）
关键词
糖尿病
2型
感染
免疫球蛋白亚类
免疫
细胞
Diabetes mellitus,type 2
Infection
Immunoglobulin subunits
Immunity,cellular
