糖尿病视网膜病变患者CD4^(+)CD25^(+)Foxp3^(+)Treg与VCAM-1、ICAM-1的变化及意义

Changes and significance of CD4^(+)CD25^(+)Foxp3^(+)Treg cells,VCAM-1 and ICAM-1 in patients with diabetic retinopathy

目的观察糖尿病视网膜病变患者CD4^(+)CD25^(+)Foxp3^(+)调节性T细胞(CD4^(+)CD25^(+)Foxp3^(+)Treg)与细胞血管黏附分子-1(VCAM-1)、细胞间黏附分子-1(ICAM-1)的变化并探讨其临床意义。方法回顾性收集并分析南充市中心医院2017年10月至2019年5月收治的112例糖尿病视网膜病变患者设为观察组,同期选择糖尿病而无视网膜病变患者112例设为对照组,并选择门诊体检的健康志愿者112例设为空白组。抽取3组研究对象空腹静脉血5 mL,采用流式细胞术检测CD4^(+)CD25^(+)Foxp3^(+)Treg细胞的比例,ELISA法检测血清VCAM-1和ICAM-1的表达水平。比较3组研究对象的CD4^(+)CD25^(+)Foxp3^(+)Treg阳性率与VCAM-1、ICAM-1表达水平差异。结果3组患者年龄、腰臂比(WHR)比较,差异无统计学意义(P>0.05);观察组和对照组BMI、空腹血糖(FPG)和糖化血红蛋白(HbA1c)表达水平与空白组比较,差异有统计学意义(P<0.05);而观察组与对照组BMI、FPG和HbA1c水平比较差异无统计学意义(P>0.05)。观察组和对照组CD4^(+)CD25^(+)Foxp3^(+)Treg阳性率低于空白组,C反应蛋白(CRP)高于空白组,且观察组CD4^(+)CD25^(+)Foxp3^(+)Treg阳性率低于对照组,差异有统计学意义(P<0.05)。观察组和对照组VCAM-1和ICAM-1均高于空白组,观察组VCAM-1和ICAM-1表达水平高于对照组,差异有统计学意义(P<0.05)。结论糖尿病视网膜病变的发生与CD4^(+)CD25^(+)Foxp3^(+)Treg及VCAM-1和ICAM-1的表达密切相关,临床医生可根据这些指标给予糖尿病患者针对性治疗。

Objective To observe the changes of CD4^(+)CD25^(+)Foxp3^(+)Treg cells,vascular cell adhesion molecule-1(VCAM-1)and intercellular adhesion molecule-1(ICAM-1)in patients with diabetic retinopathy and to explore its clinical significance.Methods A total of 112 cases of diabetic retinopathy admitted to this hospital from October 2017 to May 2019 were retrospectively collected and analyzed as the observation group.And a total of 112 patients with diabetes without retinopathy at the same time were selected as the control group,and 112 healthy volunteers from out-patient clinic were selected as the blank control group.5 mL of fasting venous blood was drawn from the three groups.The proportion of CD4^(+)CD25^(+)Foxp3^(+)Treg cells was detected by flow cytometry,and the expression levels of serum VCAM-1 and ICAM-1 were detected by ELISA.The expression levels of CD4^(+)CD25^(+)Foxp3^(+)Treg cells,VCAM-1 and ICAM-1 in the three groups were compared.Results There were no significant difference in age and WHR among the three groups(P>0.05).The BMI,FPG and HbA1c levels in the observation group and the control group were significantly different from those in the blank group(P<0.05).There was no significant difference in BMI,FPG and HbA1c between the observation group and the control group(P>0.05).The positive rate of CD4^(+)CD25^(+)Foxp3^(+)Treg cells in the observation group and the control group was lower than that in the blank control group,and C-reaction protein(CRP)was higher than that in the blank control group,and the positive rate of CD4^(+)CD25^(+)Foxp3^(+)Treg cells in the observation group was lower than that in the control group,the differences were statistically significant(P<0.05).The expression levels of VCAM-1 and ICAM-1 in the observation group and the control group were higher than those in blank control group,and the expression levels of VCAM-1 and ICAM-1 in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).Conclusion The occurrence of diabetic retinopathy is closely related to the expression of CD4^(+)CD25^(+)Foxp3^(+)Treg cells and VCAM-1 and ICAM-1.Clinicians can give targeted treatment to diabetic patients according to these indicators.