CD4^(+)/CD8^(+)在2型糖尿病合并蛋白尿患者外周血中的变化及临床意义

The Changes and Clinical Significance of CD4^(+)/CD8^(+)in Peripheral Blood of Patients with Type 2 Diabetes Mellitus Combined Albuminuria

目的探讨外周血CD4^(+)/CD8^(+)在2型糖尿病合并蛋白尿(albuminuria,AU)发生过程中的变化及临床意义。方法收集2020年3月~2021年6月于徐州医科大学附属医院内分泌科住院的2型糖尿病患者595例,根据尿微量白蛋白/肌酐比值(urinary albumin to creatinine ratio,UACR)分为非AU组(n=329)和AU组(n=266),另选取同期体检的健康人群作对照组(NC组,n=154),收集研究对象的一般资料及实验室指标,探讨CD4^(+)/CD8^(+)与2型糖尿病合并AU的关系。结果与NC组、非AU组比较,AU组的CD4^(+)/CD8^(+)显著降低(P<0.05)。2型糖尿病合并蛋白尿患者UACR与CD4^(+)/CD8^(+)呈显著负相关(P<0.001)。Logistic回归分析显示,糖尿病病程、收缩压、肌酐、超敏C反应蛋白水平升高、CD4^(+)/CD8^(+)降低可能是2型糖尿病合并AU的危险因素(OR=0.519,95%CI:0.359~0.750,P<0.001)。结论2型糖尿病合并AU患者外周血CD4^(+)/CD8^(+)降低可能在蛋白尿的发生、发展中起重要作用。

Objective To investigate the changes of CD4^(+)/CD8^(+)in peripheral blood during the development of type 2 diabetes mellitus(T2DM)with albuminuria(AU)and its clinical significance.Methods A total of 595 patients with T2DM who were admitted to the Department of Endocrinology of our hospital from March 2020 to June 2021 were selected.According to urinary microalbumin/creatinine ratio(UACR),the patients were divided into two groups:non-AU group(n=329)and AU group(n=266).154 cases of healthy people examined in our hospital during the same period as the control group(NC group).The general clinical data and the laboratory indexes of subjects were collected.The relationship between CD4^(+)/CD8^(+)and T2DM with AU was investigated.Results Compared with NC group and non-AU group,the CD4^(+)/CD8^(+)in AU group was significantly decreased(P<0.05).There was a significant negative correlation between UACR and CD4^(+)/CD8^(+)in T2DM with albuminuria(P<0.001).Logistic regression analysis showed that diabetes duration,systolic blood pressure,creatinine,hypersensitive C-reactive protein level,CD4^(+)/CD8^(+)decreased may be the risk factors of T2DM with AU(OR=0.519,95%CI:0.359-0.750,P<0.001).Conclusion The decrease of CD4^(+)/CD8^(+)in peripheral blood of patients with T2DM with albuminuria may play an important role in the development of albuminuria.