合并重症肺部感染对2型糖尿病患者凝血及免疫功能的影响

Effects of severe pulmonary infection on coagulation and immune function in patients with type 2 diabetes mellitus

目的 分析合并重症肺部感染对2型糖尿病(T2DM)患者凝血及免疫功能的影响。方法 选取2017年1月-2020年8月河池市第一人民医院收治的60例T2DM合并重症肺部感染患者为重症感染组,同期收治的60例T2DM合并普通肺部感染患者为普通感染组,确诊为单纯T2DM患者60例为对照组。检测三组入院48 h内凝血功能、纤溶指标、T淋巴细胞亚群及体液免疫功能指标。结果 重症感染组、普通感染组、对照组的凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤溶酶原激活因子(t-PA)、D-二聚体(D-D)水平依次下降,而纤维蛋白原(FIB)水平依次升高,差异有统计学意义(F=117.243、128.867、180.795、57.168、68.751、179.215,P均<0.05)。重症感染组、普通感染组、对照组的CD4^(+)、CD8^(+)及CD4^(+)/CD8^(+)、免疫球蛋白(Ig)A、IgG及IgM水平依次升高,差异有统计学意义(F=92.678、9.676、13.121、40.921、18.268、42.542,P均<0.05)。结论 合并重症肺部感染可造成T2DM患者的凝血及纤溶功能紊乱,细胞及体液免疫功能降低,临床应对此类患者给予更多关注。

Objective To analyze the effects of severe pulmonary infection on coagulation and immune function in patients with type 2 diabetes mellitus(T2DM).Methods During the period from January 2017 to August 2020,60 patients with T2DM and severe pulmonary infection admitted to Hechi First People’s Hospital were enrolled as severe infection group,another 60 T2DM patients with common pulmonary infection were enrolled as common infection group,and 60 T2DM patients were enrolled as control group.The coagulation function,fibrinolysis indexes,T lymphocyte subsets and humoral immune function indexes within 48 h after admission in the three groups were detected.Results The levels of thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT),tissue plasminogen activator(t-PA)and DDimer(D-D)in severe infection group,common infection group and control group were decreased in turn,while fibrinogen(FIB)level was increased in turn,and the differences were statistically significant(F=117.243,128.867,180.795,57.168,68.751,179.215,P<0.05).The levels of CD4^(+),CD8^(+)and CD4^(+)/CD8^(+),immunoglobulin(Ig)A,IgG and IgM in severe infection group,common infection group and control group were increased in turn,and the differences were statistically significant(F=92.678,9.676,13.121,40.921,18.268,42.542,P<0.05).Conclusions Severe pulmonary infection could cause coagulation and fibrinolysis disorders and decrease cellular and humoral immune function in T2DM patients.More attention should be paid to such patients in clinic.