老年2型糖尿病合并肺部感染患者外周血免疫指标及炎症因子变化分析

Changes of blood immune parameters and inflammatory factors in elderly patients with type 2 diabetes complicated with pulmonary infection

目的观察老年2型糖尿病合并肺部感染患者外周血免疫指标及炎症因子变化情况,分析免疫指标与炎症因子的关系。方法选取2019年1-11月在阜宁县人民医院就诊的60例老年2型糖尿病合并肺部感染患者作为合并肺部感染组,将同期收治的60例无肺部疾病的老年2型糖尿病患者作为对照组。检测患者入院时外周血中C⁃反应蛋白(CRP)、白细胞介素⁃6(IL⁃6)、肿瘤坏死因子(TNF)⁃α及免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、免疫球蛋白A(IgA)、CD3^(+)、CD8^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平。结果合并肺部感染组IL⁃6、CRP、TNF⁃α水平均高于对照组,差异有统计学意义(P<0.05)。2组IgM和IgA水平比较差异无统计学意义(P>0.05),但合并肺部感染组IgG水平低于对照组,差异有统计学意义(P<0.05)。2组CD8^(+)水平比较差异无统计学意义(P>0.05),但合并肺部感染组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平低于对照组,差异均有统计学意义(P<0.05)。IgG、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)分别与IL⁃6、CRP、TNF⁃α呈负相关(P<0.05);而IgM、IgA及CD8^(+)与IL⁃6、CRP、TNF⁃α无相关性(P>0.05)。结论老年2型糖尿病合并肺部感染患者的体液免疫和细胞免疫功能均受损伤,且其免疫功能受到炎症水平的影响,随着炎症水平的增加而降低。

Objective To observe the changes of peripheral blood immune parameters and inflammatory factors in elderly pa⁃tients with type 2 diabetes complicated with pulmonary infection,and also to analyze the relationship between immune parameters and inflammatory factors.Methods Sixty elderly patients with type 2 diabetes plus pulmonary infection who were treated in the hospital from January to November 2019 were selected as the combined pulmonary infection group or simply the infection group,while another 60 elderly patients with type 2 diabetes treated during the same period were enrolled as the control group.The levels of C⁃reactive protein(CRP),interleukin⁃6(IL⁃6),tumor necrosis factor(TNF)⁃α,immunoglobulin G(IgG),immunoglobulin M(IgM),immunoglobu⁃lin A(IgA),as well as CD3^(+),CD8^(+),CD4^(+),CD4^(+)and CD8^(+)were detected at the time of admission.Results The levels of IL⁃6,CRP and TNF⁃αin the infection group were all higher than those in the control group,with statistical significance(all P<0.05).There was no statistical significance in the levels of IgM and IgA,when comparisons were made between the two groups(P>0.05),but the IgG level in the infection group was lower than that in the control group,with statistical significance(P<0.05).There was no statistical significance in CD8^(+)when comparisons were made between the two groups(P>0.05),but the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the former were lower than those in the latter,also with statistical significance(P<0.05).The levels of IgG,CD3^(+),CD4^(+),CD4^(+)/CD8^(+)were negatively correlated with the levels of IL⁃6,CRP,and TNF⁃α(P<0.05),while the levels of IgM,IgA,and CD8^(+)had no correlation with those of IL⁃6,CRP,and TNF⁃α(P>0.05).Conclusion The humoral and cellular immune func⁃tions of the elderly patients with type 2 diabetes complicated with pulmonary infection seemed to be damaged,and the immune function of the elderly patients with type 2 diabetes was affected by inflammation,with the inflammation level decreasing with the increasing of inflammation.