结核病合并糖尿病免疫特征研究进展

Advances in immune characteristics of tuberculosis patients complicated with diabetes mellitus

目前在全世界范围内，糖尿病患病率高且呈快速上升趋势，结核病疫情下降缓慢，而糖尿病是结核病发生的重要危险因素，因此，结核病合并糖尿病日益成为结核病防控领域的新挑战。结核病合并糖尿病患者病理表现、病情、病程、治疗复杂程度、抗结核治疗失败率、死亡及复发等均与普通结核病患者不同。结核的感染及发病与机体免疫功能密切相关，在糖尿病患者或高血糖患者，其免疫功能发生改变，导致结核发病危险性的增加，同时也影响疾病的病情和预后。本文综述近年来有关结核合并糖尿病免疫学特征相关研究进展，包括固有及适应性免疫应答的改变，为结核合并糖尿病的基础研究及疾病防控提供参考。

Diabetes mellitus（ DM） rates remain highly and is increasing dramatically worldwide. Meanwhile, the incidence of tuberculosis （ TB） decreased slowly. Moreover, DM is an important risk factor for TB incidence. Therefore, TB-DM comorbidity is becoming a new challenge in the field of prevention and control of TB. TB patients complicated with DM displayed distinct pathological manifestations, severity, course of disease, treatment complexity, failure rate of anti-TB treatment, death and recurrence compared with ordinary TB patients. Infection and incidence of TB is closely related to the immune function of the host. For patients with DM or hyperglycemia, the immune function is changed, which leads to the increase of the risk of TB and also affects the condition and prognosis of the disease. The present review summarize the current advances in the study of the immunological characteristics of TB-DM comorbidity, including the changes of both innate and adaptive immune responses, aiming to provide reference for the basic research and prevention and control of TB-DM comorbidity.