VD_3对老年糖尿病性牙周炎患者Th1/Th2及免疫球蛋白的调控

Regulatory effects of VD_3 on Th1/Th2 and immunoglobulin of elderly patients with diabetic periodontitis

目的探讨维生素D3对老年糖尿病性牙周炎患者免疫功能的影响。方法选取本院收治的糖尿病性牙周炎患者65例,随机分为2组;对照组32例采用牙周基础疗法进行治疗,观察组33例在对照组的基础上加用维生素D3口服液,治疗6周,对比临床有效率;并取患者空腹静脉血清,采用流式细胞仪测定辅助性T细胞亚型(Th1、Th2)的细胞计数,同时,采用ELISA试剂盒测定免疫球蛋白(IgA、IgM、IgG)和免疫因子(IL-4、IL-10、TNF-α、IFN-γ)水平。结果有效率:观察组和对照组的临床有效率分别为96.9%,75.0%,两者相比,差异显著(χ2=5.835,P=0.013)。辅助性T细胞亚型:观察组患者血清Th2计数显著高于对照组(P<0.05),Th1计数显著低于对照组(P<0.05)。免疫球蛋白:观察组患者IgA、IgM、IgG均显著高于对照组(P<0.05)。免疫因子:观察组患者IL-4及IL-10水平显著高于对照组(P<0.05);TNF-α、IFN-γ水平显著低于对照组(P<0.05)。结论维生素D3可调节Th1/Th2比例及其相关细胞因子的分泌功能,改善糖尿病源性细胞免疫失调;同时,可促进免疫球蛋白分泌,提高老年糖尿病性牙周炎患者的体液免疫功能。

Diabetes mellitus and periodontitis,common diseases in aged people,have interaction effect with each other and contribute to diabetic periodontitis.We aim to investigate the impact of vitamin D3 on the immune function of senile patients with diabetic periodontitis through this study,in which 65 cases of patients with diabetic periodontitis accepted by our hospital were selected and randomly divided into two groups.Total of 32 cases of control group were treated with periodontal basic therapy,while 33 cases of observation group were treated with periodontal basic therapy＋VD3 oral liquid.Six weeks after,the clinical efficiency between groups were compared,and fasting venous blood of patients were extracted to determinate the cell counts of Th subsets（Th1,Th2） by flow cytometry,as well as the levels of immunoglobulin（IgA,IgM and IgG） and immune factor（IL-4,IL-10,TNF-α,IFN-γ） by ELISA kit.We found that the effective rate of observation group and control group were respective 96.9% and 75.0%,which were significantly different compared to each other.Further study showed that cell counts of Th2 in observation group were significantly higher than that in control group,while Th1 and Th1/Th2 was significantly lower.And levels of IL-4 and IL-10 in observation group were significantly higher than that in control group while TNF-α and IFN-γ were significantly lower.We also found that levels of IgA,IgM and IgG in observation group were all significantly higher than those in control group.Our research result shows that vitamin D3 can ameliorate immune disorders induced by diabetes through adjust both the proportion of Th/Ts and Th1/Th2,and also can improve patients＇ humoral immunity function by promoting immunoglobulin secretion.