外周血CD4^(+)CD25^(+)CD127^(low)在2型糖尿病足患者中的异常表达及其临床意义

Abnormal expression and its clinical significance of CD4^(+)CD25^(+)CD127^(low)Treg in peripheral blood of patients with type 2 diabetic foot

目的探讨2型糖尿病足(Diabetic foot,DF)患者外周血CD4^(+)CD25^(+)CD127^(low)Treg的水平及其临床意义。方法选择2021年1月—2022年5月在本院住院治疗的T2DM患者216例作为研究对象,其中合并DF患者139例作为DF组,单纯T2DM患者77例作为T2DM组。应用流式细胞仪检测外周血CD4^(+)CD25^(+)CD127^(low)Treg,ELISA方法检测血清中TGF-β1和IL-10含量,并进行相关性分析,各组间进行比较,采用Pearson相关分析外周血CD4^(+)CD25^(+)CD127^(low)Treg与其他指标的相关性,受试者工作特征(ROC)曲线分析外周血CD4^(+)CD25^(+)CD127^(low)Treg对DF的预测价值,用logistic多因素回归分析DF的危险因素。结果DF组患者外周血CD4^(+)CD25^(+)CD127^(low)Treg比例为(7.55±1.30)%,明显高于单纯T2DM组的(4.38±1.10)%,差异有统计学意义(P<0.05)。CD4^(+)CD25^(+)CD127^(low)Treg表达水平与IL-10(r=0.25,P=0.03)、PCT(r=0.51,P=0.01)、WBC(r=0.25,P=0.03)、HbA1c(r=0.24,P=0.03)呈正相关,与HB(r=-0.29,P=0.02)、HOMA-IR(r=-0.32,P=0.02)、BMI(r=-0.25,P=0.03)呈负相关。CD4^(+)CD25^(+)CD127^(low)Treg预测DF的ROC曲线下面积为0.882,切点值为6.45%,灵敏度和特异度分别为82.0%和80.5%。结论DF患者外周血中CD4^(+)CD25^(+)CD127^(low)Treg水平升高,对DF有一定的预测价值。

Objective To investigate the expression level and significance of CD4^(+)CD25^(+)CD127^(low)Treg in peripheral blood of patients with type 2 diabetic foot(DF).Methods A total of 216 patients with type 2 diabetes mellitus(T2DM)who were hospitalized in our hospital from January 2021 to May 2022 were selected as subjects.139 patients with DF were enrolled in the DF group,and 77 patients with only T2DM were enrolled in the T2DM group.Flow cytometry was used to measure the level of CD4^(+)CD25^(+)CD127^(low)Treg in peripheral blood,and the concentrations of TGF-β1and IL-10 were measured by ELISA kit,correlation analysis was carried out and comparison was made between each group.Then Pearson correlation analysis was used to analyzed the correlation between CD4^(+)CD25^(+)CD127^(low)Treg and other indexes.The receive operating characteristic(ROC)value curve was used to analyze the predictive value of CD4^(+)CD25^(+)CD127^(low)Treg for DF.The risk factors of DF were analyzed by logistic multivariate regression.Results The level of CD4^(+)CD25^(+)CD127^(low)Treg in DF group was(7.55±1.30%),which was significantly higher than that(4.38±1.10%)in T2DM group(P<0.05).The expression level of CD4^(+)CD25^(+)CD127^(low)Treg was positively correlated IL-10(r=0.25,P=0.03),PCT(r=0.51,P=0.01),WBC(r=0.25,P=0.03),HbA1c(r=0.24,P=0.03),however,negatively associated with HB(r=-0.29,P=0.02),HOMA-IR(r=-0.32,P=0.02)and BMI(r=-0.25,P=0.03).The area under the ROC curve of CD4^(+)CD25^(+)CD127^(low)Treg predicting DF was 0.882,the cut-off value was 6.45,and the sensitivity and specificity were 82.0%and 80.5%,respectively.Conclusions The expression level of CD4^(+)CD25^(+)CD127^(low)Treg in peripheral blood of patients with DF increased,which has certain value in predicting type 2 diabetic foot.