摘要
目的探讨CD4^+ CD28^(null)T细胞与糖尿病微血管病变的关系。方法选取内分泌科141例2型糖尿病患者,按是否存在微血管病变分为单纯糖尿病组(T2DM组)、糖尿病视网膜病变组(DR组)、糖尿病肾病组(DN组)、糖尿病视网膜病变合并糖尿病肾病组(DR+DN组)。另选择台州医院体检中心的26名健康体检者为正常对照组。比较分析各组CD4^+ CD28^(null)T细胞的表达及临床特点,并分析影响糖尿病微血管病变的相关因素。结果与对照组相比,各糖尿病组CD4^+ CD28^(null)T细胞的表达均明显升高(χ~2=19.98,P<0.01)。DR组、DN组、DR+DN组与T2DM组相比,CD4^+ CD28^(null)T细胞的表达均升高(Z=-2.19、-2.87、-2.67,均P<0.05),炎症指标CRP也升高(Z=-3.11、-2.36、-2.86,均P<0.05)。而DR组、DN组、DR+DN组之间CD4^+ CD28^(null)T细胞的表达和CRP的差异无统计学意义。Logistic回归分析显示CD4^+ CD28^(null)T细胞的表达、CRP及腰围是糖尿病微血管病变的独立影响因素。结论 2型糖尿病患者CD4^+ CD28^(null)T细胞亚群的表达高于健康体检者,而存在微血管病变的2型糖尿病患者具有更高的CD4^+ CD28^(null)T细胞亚群的表达。CD4^+ CD28^(null)T细胞可独立影响糖尿病微血管病变的进展。
Objective To investigate the relationship between CD4^＋ CD28^nullT cell and diabetic microangiopathy. Methods One hundred and forty-one patients with type 2 diabetes were selected in the endocrinology department. According to the presence of microvascular disease,these patients were divided into four groups： the type 2 diabetes patients without documented microangiopathy（ T2DM） group; the diabetic retinopathy（ DR） group; the diabetic nephropathy（ DN） group;the group with diabetic retinopathy and nephropathy（ DR ＋ DN） group. The healthy control group was consisted of 26 subjects. The expression of CD4^＋ CD28^nullT cells of these groups were compared and analyzed to find out the related factors which affects diabetic microangiopathy. Results Compared with normal control group,the expression of CD4^＋ CD28^nullT cell of all diabetic groups are significantly increased（ χ^2= 19. 98,P〈0. 01）. Compared with T2 DM group,the expression of CD4^＋ CD28^nullT cell of groups DR,DN and DR ＋ DN are significantly increased（ Z =- 2. 19,- 2. 87,- 2. 67,P〈0. 05）,and CRP of these groups are also significantly increased（ Z =- 3. 11,- 2. 36,- 2. 86,P〈0. 05）. But the differences of the expression of CD4^＋ CD28^nullT cell and CRP between groups DR,DN and DR ＋ DN have no statistical significance. The logistic regression analysis shows that the duration,the expression of CD4^＋ CD28^nullT cell,CRP and waistline are the independent risk factors for diabetic microangiopathy. Conclusion The expression of CD4^＋ CD28^nullT cell of type2 diabetes patients is higher than that of the healthy subjects. Further,these diabetes patients with microangiopathy have a higher expression. CD4^＋ CD28^nullT cell may affect the progress of diabetic microangiopathy independently.
出处
《中华全科医学》
2016年第3期415-416,448,共3页
Chinese Journal of General Practice
基金
浙江省医药卫生科技计划项目(2011KYA160)
