2型糖尿病患者外周血T淋巴细胞亚群表达与糖尿病肾脏疾病关系的研究

Study on the relationship between serum T lymphocyte subsets and diabetic kidney disease in patients with type 2 diabetes mellitus

目的探讨T2DM患者外周血T淋巴细胞亚群表达与DKD的关系。方法选取2020年7~12月于我院内分泌科治疗的T2DM患者98例,根据UAER水平分为正常白蛋白尿组(Normo)41例、微量白蛋白尿组(Micro)36例、大量白蛋白尿组(Macro)21例。另选取同期我院体检健康者20名为正常对照(NC)组,检测各组血清T淋巴细胞CD3+、CD4+、CD8+计数水平,分析其与UAER的相关性。结果Normo组CD3+、CD4+、CD8+计数水平高于NC组[(1520.59±673.84)vs(1165.20±273.08),(748.10±336.65)vs(524.50±77.27),(709.85±320.79)vs(549.95±161.31)个/μl,P<0.05],Micro组CD3+、CD4+计数水平高于Normo组[(1890.64±826.48)vs(1520.59±673.84);(1069.78±533.78)vs(748.10±336.65)个/μl,P<0.05],Macro组CD3+、CD8+计数水平低于Micro组[(1584.67±435.57)vs(1890.64±826.48),(562.14±168.09)vs(739.33±294.64)个/μl,P<0.05]。T2DM各组随着UAER升高,CD4+/CD8+比值升高[(1.24±0.65)vs(1.51±0.53)vs(1.80±0.50),P<0.05]。Spearman相关分析显示,T2DM患者UAER与外周血CD3+、CD4+计数水平及CD4+/CD8+比值呈正相关(P<0.05)。多元线性回归分析显示,TG是CD3+计数的影响因素,血肌酐是CD4+/CD8+比值的影响因素。结论 DKD患者存在T淋巴细胞亚群表达异常和比例失衡,CD4+/CD8+比值与DKD严重程度密切相关。

Objective To investigate the relation between serum T-lymphocyte subsets and diabetic kidney disease(DKD)in patients with type 2 diabetes mellitus(T2 DM).Methods A total of 98 patients with T2 DM treated in our hospital were selected in this study from July 2020 to December 2020.All the patients were divided into three groups according to the level of UAER:normoalbuminuria group(Normo group,n=41),microalbuminuria group(Micro group,n=36)and macroalbuminuria group(Macro group,n=21).Healthy people during the same period were selected as normal control group from our hospital(NC group,n=20).The levels of serum CD3 +,CD4 +,CD8 + T cells were detected in the four groups,and their relationship with UAER was analyzed.Results The levels of CD3+,CD4+,CD8+T cells were significantly higher in Normo group than in NC group[(1520.59±673.84)vs(1165.20±273.08),(748.10±336.65)vs(524.50±77.27),(709.85±320.79)vs(549.95±161.31)unit/μl,P<0.05].The levels of CD3+,CD4+ T cells were significantly higher in Micro group than in Normo group[(1890.64±826.48)vs(1520.59±673.84),(1069.78±533.78)vs(748.10±336.65)unit/μl,P<0.05].The levels of CD3 + and CD8 + T cells were lower in Macro group than in Micro group[(1584.67 ± 435.57) vs(1890.64 ± 826.48),(562.14 ± 168.09)vs(739.33 ± 294.64)unit/μl,P<0.05].CD4 +/CD8 + ratios increased significantly with the increase of UAER in T2 DM groups[(1.24±0.65)vs(1.51±0.53)vs(1.80±0.50),P<0.05].Spearman correlation analysis showed that the levels of CD3+,CD4+T cells and CD4+/CD8+ratio were positively correlated with UAER.Multiple linear regression analysis showed that TG was an influencing factor for CD3+ T cells,and Scr was an influencing factor for CD4+/CD8+ratio.Conclusion There are abnormal expression and proportion imbalance of T-lymphocyte subsets in DKD patients.CD4 +/CD8 + ratio is closely related to the severity of DKD.