糖尿病周围神经病变患者外周血Th17细胞亚群水平与TCSS评分的相关性研究

Correlation between peripheral blood Th17 cell subsets and TCSS score in patients with diabetics peripheral neuropathy

目的探讨糖尿病周围神经病变(Diabetics peripheral neuropathy,DPN)患者外周血辅助性T细胞(Thelper cell,Th)17细胞亚群水平与多伦多神经症状评分(Toronto clinical scoring system,TCSS)的相关性。方法选取2019年5月-2021年5月医院收治的88例2型糖尿病(Type 2 diabetes mellitus,T2MD)患者作为研究对象,根据周围神经受损程度将患者分为T2DM周围神经病变组(DPN组,n=48)、单纯T2DM组(n=40),参考TCSS评分将DPN患者分为轻度、中度和重度3个亚组,比较各组外周血Th17细胞亚群、白细胞介素-1β(Interleukin-1β,IL-1β)和肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)及糖脂代谢指标水平。结果DPN组的TCSS评分、胰岛素抵抗指数(Homeostasis model assessment-Insulin resistance,HOMA-IR)、外周血Th17细胞亚群、IL-1β和TNF-α水平均高于单纯T2DM组(P<0.05);DPN组外周血Th17细胞亚群、IL-1β和TNF-α水平随DPN严重程度增加而升高(P<0.05),其中重度和中度DPN组的Th17,IL-1β,TNF-α水平显著高于轻度DPN组(P<0.05);经Pearson相关性分析显示,DPN组患者TCSS评分与外周血Th17细胞亚群、IL-1β和TNF-α水平均呈显著正相关(r>0.298,P<0.05)。结论在DPN患者体内外周血Th17细胞亚群出现显著升高,且与TCSS评分具有相关性,在评估DPN严重程度分级中有一定应用价值。

Objective To explore the correlation between peripheral blood helper T cell(Th)17 subsets and score of Toronto clinical scoring system(TCSS)in patients with diabetics peripheral neuropathy(DPN).Methods A total of 88 patients with type 2 diabetes mellitus(T2MD)admitted to the hospital were enrolled as the research objects between May 2019 and May 2021.According to DPN severity,they were divided into T2DM peripheral neuropathy group(DPN group,n=48)and simple T2DM group(n=40).According to TCSS score,DPN patients were divided into mild,moderate and severe groups.The levels of peripheral blood Th17 cell subsets,interleukin1β(IL-1β),tumor necrosis factorα(TNF-α)and glucose-lipid metabolism indexes among all groups were compared.Results TCSS score,insulin resistance index(HOMA-IR),peripheral blood Th17 cell subsets,IL-1βand TNF-αin DPN group were higher than those in simple T2DM group(P<0.05).In DPN group,levels of peripheral blood Th17 cell subsets,IL-1βand TNF-αwere increased with the aggravation of DPN(P<0.05).The levels of Th17,IL-1βand TNF-αin severe and moderate DPN groups were significantly higher than those in mild DPN group(P<0.05).Pearson correlation analysis showed that TCSS score was significantly positively correlated with peripheral blood Th17 cell subsets,IL-1βand TNF-α(P<0.05).Conclusion The levels of peripheral blood Th17 cell subsets are significantly increased in DPN patients,which are correlated with TCSS score and are of certain application value in assessing the severity of DPN.