1型糖尿病患者Th细胞亚群和细胞因子的变化及其意义

目的　通过观察新诊断的 1型糖尿病患者中Th细胞亚群及其细胞因子的变化 ,了解 1型糖尿病患者中Th细胞亚群免疫功能的改变。方法　正常对照组 (N组 )和糖尿病组 (D组 )各 2 0例 ,糖尿病组再分为治疗前和治疗后 ,N组和D组 (治疗前后 )均测定空腹血糖 (FBG)、餐后 2h血糖 (P2hG)、糖化血红蛋白(HbAlc)、T淋巴细胞亚群、NK细胞活性、SIL 2R和细胞因子IFN γ、IL 4。结果　①治疗前D组CD4/CD8比值明显低于N组和治疗后 (P值均 <0 0 1) ;NK细胞活性也明显低于N组和治疗后 (P值均 <0 0 1) ;而治疗前D组SIL 2R水平明显高于N组和治疗后 (P值均 <0 0 1)。治疗 12个月后 ,D组的CD4/CD8比值、NK细胞活性和SIL 2R水平均有不同程度的恢复 ,但与N组相比差异仍有统计学意义 (P <0 0 5 )。②治疗前D组的IFN γ值明显高于N组 ,P <0 0 1,治疗后D组IFN γ值与N组的差异则无统计学差异 ;而IL 4值则无论在治疗前和治疗 12个月后均明显低于N组 ,P <0 0 1。结论　在新诊断的 1型糖尿病患者中存在着T淋巴细胞亚群、Th淋巴细胞亚群及其分泌的细胞因子的改变 ,提示 1型糖尿病的发生和发展与免疫功能的改变是密切相关的。

Changes of Th lymphocytes and their cytokines in patients with type 1 diabetes mellitus

Objective To observe the changes of Th lymphocytes and their cytokines in patients with type 1 diabetes mellitus.Methods 40 peoples were divided into normal control group(group N,20 cases) and diabetic group(group D,20 cases).Group D again was divided into two sub groups,i.e. before and after 12M's treatment.CD 4/CD 8 ratio,activity of NK cell,SIL 2R levels and cytokines(IFN γ,IL 4) et al. were measared in each group.Results (1)In group D,the CD 4/CD 8 ratio and the activity of NK cell before treatment were significantly lower than those after treatment and group N;the SIL 2R level before treatment was significantly higher than those after treatment and group N(P<0.01).After 12M's treatment,the parameters above were partly recovered,but the differences were still existed compared with group N(P<0.05).(2)IFN γ level before treatment was significatly higher than that after treatment and group N;while IL 4 levels in group D were significantly lower than group N in spite of the treatment.Conclusion There are changes of the T lymphocytes,Th lymphocytes and cytokines in the patients with type 1 diabetes mellitus.It is possible for us to prevent and treat type 1 diabets with immunological means.