妊娠期糖尿病患者母儿免疫水平变化的临床研究

目的:研究妊娠期糖尿病(GDM)患者母儿免疫球蛋白(Ig)、补体(C)、T淋巴细胞亚群以及NK细胞水平的变化,探讨GDM对母儿体液免疫和细胞免疫的影响。方法:选择58例不同糖耐量水平的GDM患者为研究对象根据是否需要胰岛素治疗进一步分为GDM1组和GDM2组,以30例健康孕妇做对照。免疫比浊法测定外周静脉血与脐血的免疫球蛋白、补体水平;流式细胞技术测定外周静脉血与脐血的T细胞亚群及NK细胞水平。结果:GDM组外周血CD4+、CD4+/CD8+、CD16+CD56+、IgG含量均下降,CD8+、C3、C4、IgE含量升高,差异有统计意义(P<0.05);CD3+、IgA、IgM含量下降,差异无统计学意义(P>0.05)。GDM组脐血中CD3+、CD4+、CD4+/CD8+、CD16+CD56+含量均下降,差异有统计学意义(P<0.05);IgM、IgG含量下降,CD8+、IgE含量升高,差异无统计学意义(P>0.05)。与GDM1组相比,GDM2的指标呈现更明显的变化趋势。结论:妊娠期糖尿病存在母儿体液免疫和细胞免疫的失衡,且病情越重,这种改变越显著。

Clinical research on immunologic function of gestational diabetes mother and their infants

Objective:Investigate changes of immunglobulin(Ig),complements(C),T lymphocyte subsets and natural kill(NK)cells in gestational diabetes mellitus(GDM) mothers and their neonates,to discussion the effect of GDM on the humoral and cellular immunity.Methods:58 cases of different levels of glucose tolerance in patients with GDM and 30 healthy pregnant women were determined by immune turbidimetric method with peripheral blood and cord blood for immunoglobulin,complement levels;and their peripheral blood and cord blood were determined by flow cytometry determination for T cell subsets and NK cells.The GDM patients were subgrouped to GDM1 and GDM2 according to using or not using insulin.Results:CD4+,CD4+/CD8+,CD16+CD56+levels in peripheral blood of GDM patients were decreased,CD8+,C3,C4 levels increased,the difference was statistically significant(P<0.05);CD3,IgG content decreased,IgE levels increased,the difference was not statistically significance(P>0.05).Cord blood in GDM group’s CD3+,CD4+,CD4+/CD8+,CD16+CD56+levels were decreased,the difference was statistically significant(P<0.05);IgE,IgM,IgG content decreased,CD8+content increased,the difference was not statistically significant(P>0.05).CDM2 group showed more significant trendency of changes in all indicators coupared with GDM1 group.Conclusion:GDM can bring changs and imbalance to body fluid immunity and cell immunity to both mother and baby.The more severity the imblance of glucose metabolism,the more obvious the changes of the indicators.