颈交感神经干离断对2型糖尿病大鼠围术期T淋巴细胞亚群及IL-2和IL-6的影响

目的 探讨颈交感神经干离断(TCST)对2型糖尿病大鼠围术期T淋巴细胞亚群及白细胞介素(IL)-2、IL-6的影响.方法 清洁级健康成年雄性SD大鼠,10~12周龄,体重250~280 g,采用高脂高糖饮食复合腹腔注射链脲佐菌素(STZ)制备2型糖尿病大鼠模型.取模型制备成功的大鼠90只,采用随机数字表法分为3组:糖尿病组(D组)、糖尿病+剖腹探查组(DO组)和糖尿病+ TCST+剖腹探查组(DTO组),每组30例.于糖尿病模型制备成功1周后,DTO组行右侧TCST术制备TCST模型,D组和DO组仅分离右颈交感神经干,不离断.DO组和DTO组于TCST模型制备成功1周后行剖腹探查术,分别于切皮前(T0)、术毕(T1)、术后第1天(T2)、术后第3天(T3)和术后第7天(T4)随机取6只大鼠,测定3组大鼠尾静脉血糖,采集血样后处死,采用ELISA法检测血浆去甲肾上腺素(NE)、IL-2和IL-6浓度,流式细胞术测定CD3+、CD4+、CD8+T细胞百分比,并计算CD4+/CD8+比值.结果 与D组比较,DO组T1~T4时血糖、血浆NE和IL-6浓度明显升高,CD3+、CD4+T细胞百分比、CD4+/CD8+比值和IL-2浓度明显降低(P<0.05);与DO组比较,DTO组T1~T4时血糖、血浆NE和IL-6浓度明显降低,CD3+、CD4+T细胞百分比、CD4+/CD8+比值和血浆IL-2浓度明显升高(P<0.05).结论 TCST可升高2型糖尿病大鼠围术期CD3+、CD4+T细胞百分比、CD4+/CD8+比值和血浆IL-2浓度,有助于改善2型糖尿病大鼠围术期细胞免疫功能.

Effect of transection of the cervical sympathetic trunk on T-lymphocyte subsets,IL-2 and IL-6 in type 2 diabetic rats during perioperative period

Objective To investigate the effect of transection of the cervical sympathetic trunk (TCST) on T-lymphocyte subsets, IL-2 and IL-6 in type 2 diabetic rats during perioperative period.Methods Pathogen-free male Sprague-Dawley rats, aged 10~12 weeks, weighing 250~280 g, were studied.Type 2 diabetic rats were induced by a combination of high-fat and high-glucose diet with intraperitioneal injection of streptozotocin (STZ).Ninety diabetic rats were randomly divided into 3 groups (n=20), diabetes mellitus group (Group D), diabetes mellitus plus exploratory laparotomy group (Group DO) and diabetes mellitus plus TCST plus exploratory laparotomy group (Group DTO).The right side of cervical sympathetic trunk was transected 1 week after the model of diabetes successfully induced in group DTO.The right side of cervical sympathetic trunk was only exposed but not cut in Group D and DO.Exploratory laparotomy was performed 1 week after the model of TCST successfully established in Group DO and DTO.Blood samples were obtained from each group before skin incision (T0), at the end of operation (T1), and 1 day (T2), 3 days (T3) and 7 days (T4) after operation, for determination of blood glucose.And plasma concentration of noradrenaline (NE), interleukin-2(IL-2), interleukin-6(IL-6), the percentages of T lymphocyte subsets (CD3+, CD4+, CD8+) were detected with flow cytometry, as the CD4+/CD8+ ratio was calculated.Results Compared with Group D, the blood glucose, the plasma concentrations of NE and IL-6 in Group DO at T1 to T4 were significantly increased, while the percentages of CD3+ and CD4+ T cells, the CD4+/CD8+ ratio and the plasma concentration of IL-2 were significantly decreased (P<0.05).Compared with Group DO, the blood glucose, the plasma concentration of NE and IL-6 in Groups DTO at T1 to T4 were significantly reduced, while the percentages of CD3+ and CD4+ T cells, the CD4+/CD8+ ratio and the plasma concentration of IL-2 was significantly increased (P<0.05).Conclusion Transection of the cervical sympathetic trunk increase the percentages of CD3+ and CD4+T cells, CD4+/CD8+ ratio and the plasma concentration of IL-2, which can improve the cell-mediated immune function in type 2 diabetic rats.