老年2型糖尿病合并骨质疏松症免疫功能分析及微量营养素干预治疗

The Effect of Micronutrient Therapy on the Change of Immune Function on Elderly Patients with Type 2 Diabetes and Osteoporosis

目的:探讨老年2型糖尿病合并骨质疏松症患者免疫功能状况,以及微量营养素干预治疗对其的影响。方法:选择2014年1月—2015年12月在我院代谢内分泌科住院患者200例,根据诊断分为老年2型糖尿病合并骨质疏松组(n=100)与糖尿病组(n=100),另有健康体检者纳入对照组(n=100)。针对上述受试对象进行T淋巴细胞亚群和骨密度检测,同时针对老年2型糖尿病合并骨质疏松组给予微量营养素干预治疗。结果:与对照组相比,糖尿病组与老年2型糖尿病合并骨质疏松组患者CD3+、CD8+细胞水平降低,CD4+细胞水平增高(P<0.05);与糖尿病组相比,老年2型糖尿病合并骨质疏松组甲状旁腺激素(PTH)和骨碱性磷酸酶(BALP)水平升高,而骨密度(BMD)降低(P<0.05);与治疗前相比,老年2型糖尿病合并骨质疏松组治疗后CD4+、CD8+以及CD4+/CD8+有明显改善(P<0.05),腰椎及股骨颈BMD值也有明显改善(P<0.05)。结论:老年2型糖尿病合并骨质疏松组存在T淋巴细胞紊乱和骨密度下降,在严格控制血糖的同时,应用碳酸钙、骨化三醇、多维元素治疗,可使多数糖尿病患者的免疫功能和代谢紊乱得以改善。

Objective： To investigate the effect of micronutrient therapy on the change of immune function on elderly patients with type 2diabetes and osteoporosis. Methods： Selecting 200 patients from the inpatient department in our hospital,and all the patients were randomly divided into three groups. 100 patients with type 2 diabetes and osteoporosis were in DM/OP group,100 patients with diabetes was in DM group,and another 100 healthy people was in control group. All the patients was checked the number of T cells and bone mass density,and the micronutrient therapy was gave on the elderly patients with type 2 diabetes and osteoporosis. Results： To compare with control group,the higher T cell number in patients from group DM/OP and DM（P〈0. 05）. To compare with DM group,the greater PTH level,bone alkaline phosphatase,and bone mass density in patients in DM/OP group（P〈0. 05）. After micronutrient therapy,higher T cell number and bone mass density in group DM/OP（P〈0. 05）. Compared with pre-therapy,CD4＋,CD8＋and CD4＋/CD8＋in patients with type 2 diabetes mellitus combined with osteoporosis improved significantly（P〈0. 05）,and the BMD values of lumbar and femoral neck were improved（P〈0. 05）. Conclusions： The micronutrient therapy can improve the immune function and bone mass density in patients with type diabetes and osteoporosis.