早期糖尿病肾病微炎症状态对T淋巴细胞免疫功能的影响

目的探讨微炎症状态对早期糖尿病肾病患者T淋巴细胞免疫功能的影响。方法检测23例2型糖尿病(DM)患者、26例早期糖尿病肾病(DN)患者及20例健康对照者血清超敏C反应蛋白(hs-CRP),分离淋巴细胞并检测PHA刺激的淋巴细胞增殖反应和白介素-2(IL-2)表达,分析hs-CRP与PHA刺激的淋巴细胞增殖反应和IL-2表达的关系。结果DM患者血清hs-CRP为(3.25±1.64)μg/L,明显高于正常对照组的(1.07±0.65)μg/L(P<0.05),而DN组血清hs-CRP为(7.42±4.16)μg/L明显高于DM组(P<0.05)。DN组PHA刺激的淋巴细胞增殖反应、IL-2分泌较对照组和DM组均显著降低(P<0.05)。在DN组中,hs-CRP与PHA刺激的淋巴细胞增殖、IL-2分泌呈负相关(r=-0.652,P<0.05;r=-0.715,P<0.05),其他各组无明显相关性。结论早期糖尿病肾病患者存在微炎症和细胞免疫功能下降,两者明显呈负相关,消除或控制促炎因素,可能对改善早期糖尿病肾病患者免疫功能障碍有益。

Effect of microinflammatory state on T lymphocyte immunity in early diabetic nephropathy

Objective To study the effect of microinflammatory state on T lymphocyte immunity in early diabetic nephropathy(DN). Methods 23 patients with normal urinary albumin excretion rate were taken as DM group, 26 patients with microalbuminuria was DN group,20 health persons was the control group. The supersensitivity C-reactive protein were determined in the three groups. The proliferation response and IL-2 secreting of T lymphocyte stimulated by PHA were measured in order to analyze the relationship of hs-CRP to T lymphocyte immunity.Results The serum level of hs-CRP in DM group(3.25±1.64) was significantly higher than those of control group(1.07±0.65,P<0.05), while it in DN group(7.42±4.16) was much higher than DM group (P<0.05). The proliferation response and IL-2 secreting of T lymphocyte stimulated by PHA in DN group were obviously depressed compared with DM group and control group. Inverse correlations were found among serum hs-CRP with the proliferation response and IL-2 secretion (r=-0.652,P<0.05;r=-0.715,P<0.05).Conclusion Microinflammatory and cellular immune function degression are present in early diabetic nephropathy,which has inverse correlations. To eliminate or to control the inflammation factors may be beneficial to improve the cellular immune function in early diabetic nephropathy.