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目的观察糖尿病慢性肾脏疾病(CKD)患者外周血免疫调节T淋巴细胞的变化。方法选取67例T2DM患者,根据UAER将其分为单纯T2DM组39例和CKD组28例,同时选取28名健康体检者作为正常对照组(NC)。采用流式细胞术(FCM)分别检测3组外周血Th1细胞、Th2细胞、调节性T细胞(Treg)等免疫细胞亚群。结果 NC组、T2DM组及CKD组外周血中Th1细胞比例分别为(17.43±5.15)%、(20.13±5.49)%及(27.30±8.37)%;Th1/Th2比值分别为(13.7±5.4)%、(23.07±14.42)%及(36.44±38.87)%;Treg细胞比例分别为(2.33±1.04)%、(1.10±0.48)%及(0.83±0.42)%。与NC组及T2DM组比较,CKD组Th1细胞比例、Th1/Th2比值升高,Treg细胞比例降低(P<0.05)。Spearman相关分析显示,T2DM患者UAER与Th1细胞比例、Th1/Th2比值呈正相关,与Treg细胞比例呈负相关。多元逐步回归分析显示,TG是Th1的影响因素,HbA_1c及DBP是Th2及Th1/Th2比值的影响因素,DBP及TG是Treg的影响因素。结论 CKD患者外周血中存在Treg数目减少及Th1/Th2失衡。
Objective To observe the changes of peripheral blood immunoregulatory T lymphocytes in diabetic patients with chronic kidney disease (CKD). Methods Sixty-seven patients with T2DM were selected and divided into three groups according to UAER: 39 cases of simple T2DM group and 28 cases of CKD group. Meanwhile, 28 healthy subjects were selected as normal control group (NC). Flow cytometry (FCM) were used to detect peripheral blood Th1 cells, Th2 cells, regulatory T cells (Tregs) and other immune cell subgroups. Results The proportion of Th1 cells in NC group, T2DM group and CKD group were (17.43 ± 5.15)%, (20.13 ± 5.49)% and (27.30 ± 8.37)%, respectively. Th1 / Th2 ratios were 13.7 ± 5.4% , (23.07 ± 14.42)% and (36.44 ± 38.87)%, respectively. The percentage of Treg cells were (2.33 ± 1.04)%, (1.10 ± 0.48)% and (0.83 ± 0.42)%, respectively. Compared with NC group and T2DM group, the proportion of Th1 cells, the Th1 / Th2 ratio and the percentage of Treg cells in CKD group decreased (P <0.05). Spearman correlation analysis showed that there was a positive correlation between UAER and Th1 cell ratio and Th1 / Th2 ratio in T2DM patients, but negatively correlated with Treg cell ratio. Multiple stepwise regression analysis showed that TG was the influencing factor of Th1, HbA1c and DBP were the influencing factors of Th2 and Th1 / Th2 ratio, and DBP and TG were the influencing factors of Treg. Conclusion There is a decrease of Treg number and imbalance of Th1 / Th2 in peripheral blood of CKD patients.