老年代谢综合征患者血清免疫球蛋白及T淋巴细胞亚群检测及意义

Tests of serum immunoglobulin and T lymphocyte subsets and their significance in elderly patients with metabolic syndrome

目的通过检测老年代谢综合征(MS)人群的免疫球蛋白及T淋巴细胞亚群的变化分析其免疫状态。方法采用透射比浊法测定免疫球蛋白(IgG、IgM和IgA)及流式细胞仪分析T淋巴细胞亚群(CD3+、CD4+、CD8+)在老年代谢综合征和健康老年体检者的分布情况。结果 MS患者中4项指标均异常的占10.49%(30/286),3项指标异常的占29.37%(84/286),其中最多见的组合是体重指数(BMI)、高血压和高血糖,两项指标异常占60.14%(172/286)。老年代谢综合征患者IgM、IgA及CD3+、CD4+均低于对照组,IgG和CD8+计数高于对照组,差异均有统计学意义,并且异常指标越多其免疫状态越差。结论老年代谢综合征患者由于肥胖、高血压和胰岛素抵抗等因素,使机体免疫细胞活性受到抑制,出现不同程度的非特异性免疫功能障碍。检测老年代谢综合征患者的血清免疫球蛋白及T淋巴细胞亚群可及时分析其免疫状态,为后期的治疗提供一定的参考。

Objective To test the changes of immunoglobulin and T lymphocyte subsets in elderly patients with metabolic syndrome （MS）, and to analyze their immune state. Methods Transmission turbidimetry and flow cytometry were applied to measure and analyze the distribution of immunoglobulin （IgG, IgM and IgA） and T lymphocyte subsets in elderly patents with MS and healthy elderly controls. Results Among MS patients, patients with 4 abnormal indices accounted for 10.49% （30/286）, patients with 3 abnormal indices accounted for 29.37% （84/286）, in which the most commonly seen combination were BMI, hypertension and hyperglycemia. Patients with 2 abnormal indices accounted for 60.14% （172/286）. IgM, IgA and CD3^＋, CD4^＋ in MS patients were all lower than those in the control group, the counts of IgG and CD8^＋ were higher than those in the control group, and the differences were all statistically significant. The more the abnormal indices, the worse the immune state. Conclusion Due to factors such as obesity, hypertension and insulin resistance in elderly MS patients, the activity of immunocytes is inhibited, and different degrees of non-specific immunity dysfunction occur. The tests of immunoglobulin and T lymphocyte subsets in elderly patients with MS are able to analyze their immune state timely, and to provide references for subsequent treatment.