糖尿病胫前黑斑患者TH17、Treg的表达及其与糖尿病足的相关性研究

The Expression of TH17 and Treg in Diabetic Anterior Tibial Melanoma and Its Correlation with Diabetic Foot

目的观察糖尿病伴胫前黑斑患者的临床特征,并探讨与TH17、Treg细胞表达的关系及与糖尿病足发病的相关性。方法选取2017年1月—2020年12月收集糖尿病伴胫前黑斑及无胫前黑斑患者,进行临床特征分析,应用流式细胞仪测定患者外周血TH17、Treg细胞比例、ELISA测定外周血IL-17/IL-10/TGF-β细胞因子,对比糖尿病胫前黑斑组和无胫前黑斑组的免疫指标。结果与无伴胫前黑斑组相比,伴胫前黑斑组糖尿病患者,糖尿病视网膜病变、尿ACR升高、糖尿病足的发生率较高,差异有统计学意义(P<0.05)。糖尿病患者伴和不伴胫前黑斑组外周血中Th17细胞比例以及IL-17的水平均高于正常对照组,Treg细胞比例以及TGF-β、IL-10水平均低于正常对照组,糖尿病伴胫前黑斑患者组外周血Treg细胞比例和TGF-β、IL-10表达进一步低于糖尿病无胫前黑斑患者组,差异有统计学意义(P<0.05)。结论糖尿病合并胫前黑斑患者糖尿病足发生率升高,胫前黑斑发病可能与TH17/Treg细胞比例失衡导致细胞因子分泌变化引起免疫炎症相关。

Objective To observe the clinical characteristics of patients with pretibial erythema and explore the relationship between TH17,Treg cell expression and the onset of diabetic foot.Methods Selected from January 2017 to December 2020 collected diabetic patients with anterior tibial dark spots and no anterior tibial dark spots for clinical analysis.Use flow cytometry to determine the proportion of TH17 and Treg cells in the peripheral blood of the patient,and ELISA to determine the peripheral blood IL-17/IL-10/TGF-β cytokine,compare the immune indexes of the diabetic anterior tibial dark spot group and the non-tibial dark spot group.Results Compared with the group without anterior tibial black spot,the diabetic patients with anterior tibial black spot had a higher incidence of diabetic retinopathy,increased urinary ACR,and diabetic foot,and the difference was statistically significant( P <0.05).Peripheral blood Th17 cells and IL-17 levels in diabetic patients with or without anterior tibial black spots were higher than those in the normal control group,and the Treg cell ratios,TGF-β and IL-10 levels were lower than those in the normal control group,the proportion of peripheral blood Treg cells and the expression of TGF-β and IL-10 in the diabetic group with anterior tibial dark spots were further lower than those in the diabetic group without anterior tibial dark spots,and the difference was statistically significant( P <0.05).Conclusion The incidence of diabetic foot in patients with pretibial erythema increases,and pretibial erythema may be associated with cytokinine secretion due to imbalance of TH17/Treg cells.