探讨新发T1DM并DKA儿童免疫功能状态分析

Analysis of immune function status in children with new-onset T1DM and DKA

目的通过观察新发1型糖尿病(Type 1 diabetes mellitus,T1DM)并酮症酸中毒(Diabetic ketoacidosis,DKA)儿童的体液免疫及细胞免疫水平,探讨其免疫状态。方法选取我院住院治疗的新发T1DM并DKA儿童40例为观察组,健康儿童20例为对照组,并测定其免疫球蛋白、细胞因子的水平和淋巴细胞亚群的细胞数与百分数。结果(1)观察组IgA水平较对照组显著性增高(P<0.05);IgE、IgG、IgM水平组间差异无统计学意义;(2)观察组IL-1B、IL8、IFN-γ水平较对照组显著性增高(P<0.05);IL2R、IL6、IL10、IL17、TNFα水平组间差异无统计学意义;(3)观察组B淋巴细胞及CD4^(+)CD8^(+)双阳性T淋巴细胞较对照组显著性增高(P<0.05),NK细胞数较对照显著性降低(P<0.05);总T淋巴细胞、T4淋巴细胞、T8淋巴细胞及T4/T8组间差异无统计学意义;结论新发T1DM并DKA儿童存在体液免疫功能异常,部分炎症因子水平增高,并存在B淋巴细胞与T淋巴细胞的双重功能异常,淋巴细胞亚群功能紊乱可能是导致儿童T1DM的重要因素。

Objective To investigate the immune status by observing the humoral and cellular immunity and cytokine levels in children with new-onset type 1 diabetes mellitus(T1DM) and ketoacidosis(DKA).Method 40 children with new-onset T1DM and DKA hospitalized in our hospital were selected as the observation group,and 20 healthy children were selected as the control group.The levels of immunoglobulins,cytokines,and the number and percentage of lymphocyte subsets were determined.Results(1) The level of IgA in the observation group was significantly higher than that in the normal control group(P<0.05);there was no statistical difference in the levels of IgE,IgG and IgM between the groups;(2) the levels of IL-1B,IL8 and IFN-γ in the observation group Compared with the normal control group,the levels of IL2R,IL6,IL10,IL17 and TNFα were not significantly different between groups;(3) B lymphocytes and CD4^(+)CD8^(+)double positive T lymphocytes in the observation group were higher than those in the normal control group.Compared with the normal control group,the number of NK cells was significantly increased(P<0.05),and the number of NK cells was significantly decreased(P<0.05);there was no statistical difference between the total T lymphocytes,T4 lymphocytes,T8 lymphocytes and T4/T8 groups;Conclusion Children with new-onset T1DM and DKA have abnormal humoral immune function,increased levels of some inflammatory factors,and dual dysfunction of B lymphocytes and T lymphocytes.The dysfunction of lymphocyte subsets may be an important factor leading to children with T1DM.