CD4^+CD25^+T细胞在2型糖尿病患者中的表达及与临床预后的相关性

The level of CD4^+CD25^+T cells in serum of patients with type 2 diabetes and its correlation with the prognosis

目的探讨糖尿病患者血清中CD4^+CD25^+T细胞水平与胰岛素强化效果及患者临床预后的关系。方法选取本院2015年9月-2016年6月在院治疗的98例2型糖尿病患者作为观察组,另收集同期健康体检者60例作为对照组,检测患者血清中CD4^+CD25^+T细胞水平。采用Logistic回归分析探讨影响糖尿病患者临床预后的危险因素。结果对照组血清中CD4^+CD25^+T细胞明显低于观察组,而Th17细胞明显高于观察组,差异有统计学意义(P<0.05);CD4^+CD25^+T细胞高水平组观察组患者GLU、HOMA-IR、Hb A1C均高于CD4^+CD25^+T细胞低水平患者,而FIN水平低于CD4^+CD25^+T细胞低水平患者,差异有统计学意义(P<0.05);多因素分析提示,CD4^+CD25^+T细胞、BMI指数是糖尿病患者死亡的独立危险因素(P<0.05)。结论糖尿病早期胰岛素降糖有助于提高糖尿病患者治疗效果,血清中CD4^+CD25^+T细胞水平与患者免疫功能、临床降糖效果密切相关。

Objective To investigate the relationship between the serum level of CD4＋CD25＋T cells in patients with diabetes mellitus and the prognosis. Methods 98 patients with type 2 diabetes in our hospital from September 2015 to June 2016 were selected as the observation group,and 60 healthy people were collected as the control group. CD4＋CD25＋T cells of all patients were detected,and Logistic regression analysis was used to explore the prognostic risk factors in diabetic patients. Results The serum levels of CD4＋CD25＋T cells in the control group were significantly lower than those in the observation group,while the Th17 cells were significantly higher than those in the observation group,with the differences statistically significant（ P 〈0. 05）.The levels of GLU,HOMA-IR,Hb A1 Cin the high level CD4＋CD25＋Treg cells group were higher than the low level group,while,the FIN level was lower than the CD4＋CD25＋Treg low level group,with the differences statistically significant（ P〈 0. 05）; multivariate analysis showed that CD4＋CD25＋T cells and BMI index were the independent risk factors of death in patients with diabetes mellitus（ P 〈0. 05）. Conclusion Insulin hypoglycemic therapy can help to improve the therapeutic effect of diabetic patients in the early stage,and the serum levels of CD4＋CD25＋T cells are closely related to the immune function and clinical hypoglycemic effect.