维生素D水平与2型糖尿病并发肺部感染患者免疫功能及其预后的关系

Relationship between vitamin D level and immune function, prognosis of type 2 diabetes mellitus patients complicated with pulmonary infection

目的 分析维生素D水平与2型糖尿病并发肺部感染患者免疫功能失调及预后的关系。方法 选取2019年2月-2020年2月南阳医学高等专科学校第一附属医院收治的2型糖尿病患者为研究对象,其中42例合并肺部感染患者为感染组,58例未合并肺部感染患者为未感染组。比较两组患者糖代谢指标、免疫功能指标及25羟维生素D[25(OH)D]水平,分析肺部感染者病原菌分布及25(OH)D水平与预后的相关性。结果 感染组患者空腹血糖(FBG)为(10.27±3.51)mmol/L、糖化血红蛋白(HbAlc)水平为(9.72±3.15)%均高于未感染组(P<0.05),25(OH)D水平(44.28±15.25)mmol/L低于未感染组(P<0.05),感染组患者CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)水平均低于未感染组(P<0.05),42例2型糖尿病并发肺部感染组预后不良患者25(OH)D水平低于预后良好组(P<0.05),感染患者共检出51株病原菌,其中革兰阴性菌32株占62.75%。结论 25(OH)D水平与2型糖尿病并发肺部感染患者免疫功能有一定的相关性,其可能会影响患者的预后。

OBJECTIVE To analyze the relationship between vitamin D level and immune function,prognosis of the type 2 diabetes mellitus patients complicated with pulmonary infection.METHODS The patients with type 2 diabetes mellitus who were treated in the First Affiliated Hospital of Nanyang Medical College from Feb 2019 to Feb 2020 were recruited as the study sujects,42 of whom were complicated with pulmonary infection and were assigned as the infection group,58 patients were not complicated with pulmonary infection and were set as the no infection group.The glucose metabolism indexes,immune function indexes and 25-hydroxyvitamin D[25(OH)D]levels were compared between the two groups of patients,and the association between the distribution of pathogens,25(OH)D and the prognosis was observed.RESULTS The levels of fasting blood glucose(FBG)and glycosylated hemoglobin(HbAlc)of the infection group were respectively(10.27±3.51)mmol/L and(9.72±3.15)mmol/L,significantly higher than those of the no infection group(P<0.05).The 25(OH)D level of the infection group was(44.28±15.25)mmol/L,significantly lower thanthat of the no infection group(P<0.05).The levels of CD_(3)^(+),CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+)of the infection group were significantly lower thanthose of the no infection group(P<0.05).Among the 42 type 2 diabetes mellitus patients complicated with pulmonary infection,the 25(OH)D level of the patients with poor prognosis was significantly lower thanthat of the patients with favorable prognosis(P<0.05).A total of 51 strains of pathogens were isolated from the patients with infection,32(62.75%)of which were gram-negative bacteria.CONCLUSION There is certain correlation between the 25(OH)D level and the immune function of the type 2 diabetes mellitus patients complicated with pulmonary infection,and it may affect the prognosis of the patients.