糖尿病合并耐药结核患者外周血T细胞亚群分析

T lymphocyte subsets in peripheral blood of patients with diabetes mellitus complicated with drugresistanttuberculosis

目的 分析糖尿病合并耐药结核患者外周血T细胞亚群特点。方法 选取太原市第四人民医院2020年11月至2022年3月糖尿病合并肺结核患者60例(合并组),单纯肺结核患者60例(未合并组),和同期60名健康体检者(健康对照组),同时依据药敏结果将合并组患者分为敏感组(32例)和耐药组(28例),分析比较各组患者外周血T细胞亚群特点。结果 与健康对照组相比,未合并组、合并组CD4^(+)%、CD4/CD8比值依次降低,CD8^(+)%依次升高,差异均有统计学意义(P<0.01);合并组中耐药组与敏感组相比,CD4^(+)%、CD4^(+)/CD8^(+)比值进一步降低,CD8^(+)%升高(P<0.01)。结论 T细胞亚群介导的细胞免疫功能紊乱是糖尿病合并耐药结核发生的关键因素。针对该方向所制定的治疗策略,有望成为有效地改善患者病情及预后的新途径。

Objective To investigate the characteristics of peripheral blood T lymphocyte subsets in patients with diabetes mellitus complicated with drug-resistant tuberculosis.Methods A total of 60 patients with diabetes complicated with tuberculosis(combined group)and 60 patients with simple tuberculosis(non-combined group)were selected from the Fourth People′s Hospital of Taiyuan from November 2020 to March 2022,and 60 healthy subjects(healthy control group)at the same time,according to the drug sensitivity results,patients in the combined group were divided into the sensitive group(32 cases)and the drug-resistant group(28 cases),and the characteristics of peripheral blood T lymphocyte subsets of patients in each group were analyzed and compared.Results Compared with the healthy control group,CD4^(+)%and CD4/CD8 ratio were decreased and CD8^(+)%were increased successively in the non-combined group and combined group,the differences were statistically significant(P<0.01).Compared with the sensitive group,CD4^(+)%and CD4^(+)/CD8^(+)ratio were further decreased and CD8^(+)%was increased in the drug-resistant group(P<0.01).Conclusion The cellular immune dysfunction mediated by T lymphocyte subsets is a key factor in the occurrence of diabetes mellitus complicated with drugresistant tuberculosis.The therapeutic strategies developed in this direction are expected to be a new way to effectively improve the condition and prognosis of patients.