糖尿病合并感染患者糖化血红蛋白与T淋巴细胞亚群水平相关分析

目的 探讨糖尿病合并感染患者糖化血红蛋白与T淋巴细胞亚群CD3⁺、CD4⁺及CD8⁺水平变化相关性。方法 选取2019年1月—2021年4月泸州市人民医院收治112例糖尿病患者为病例组,以同期接受健康体检的80例为对照组,糖尿病患者根据是否合并感染依次分感染组48例和无感染组64例,观察各组糖化血红蛋白（HbA1c）和T淋巴细胞亚群CD3⁺、CD4⁺及CD8⁺水平变化情况,并分析HbA1c与CD3⁺、CD4⁺及CD8⁺水平相关性;分析糖尿病感染组患者治疗前后CD3⁺、CD4⁺及CD8⁺水平变化。结果 病例组和对照组空腹血糖、餐后2 h血糖以及HbA1c分别为（9.24±0.89）mmol/L和（4.81±0.63）mmol/L、（14.98±1.56）mmol/L和（6.14±0.48）mmol/L、（7.47±0.89）% 和（4.05±0.35）%,病例组显著高于对照组,差异有统计学意义（t=15.012,14.614,12.266,P<0.05）,糖尿病合并感染组空腹血糖、餐后2 h血糖以及HbA1c虽高于无感染组,但差异无统计学意义（P>0.05）;糖尿病合并感染组和无感染组CD3⁺和CD4⁺水平分别为（60.32±2.14）%和（65.57±2.53）%、（33.18±1.59）%和（37.42±1.74）%（t=11.596,13.237,P<0.05）,两组CD8⁺水平差异无统计学意义（P>0.05）;经Pearson相关性分析,HbA1c与CD3⁺和CD4⁺呈负相关（r=-0.354,-0.512,P<0.05）,与CD8⁺呈正相关（r=0.336,P<0.05）;感染组治疗后CD3⁺和CD4⁺显著升高,治疗前后比较差异具统计学意义（t=9.518,8.217,P<0.01）。结论 糖尿病患者血糖水平升高,免疫机能减弱,HbA1c与CD3⁺和CD4⁺呈负相关,与CD8⁺呈正相关。

Correlation between glycosylated hemoglobin and T lymphocyte subsets in patients with diabetes mellitus and infection

Objective To investigate the correlation between glycosylated hemoglobin (HbA1c) and changes in T lymphocyte subsets CD3⁺, CD4⁺ and CD8⁺ in patients with diabetes mellitus and infection. Methods Totally 112 patients with diabetes mellitus admitted to Luzhou Municipal People's Hospital between January 2019 and April 2021 were selected as the case group, and 80 healthy volunteers who received physical examination in the hospital during the same period were selected as the control group. Patients enrolled were divided into infected group (n=48) and uninfected group (n=64) according to the presence or absence of infection. Changes in the levels of HbA1c and T lymphocyte subsets CD3⁺, CD4⁺ and CD8⁺ in each group were observed. The correlation between HbA1c and the levels of CD3⁺, CD4⁺ and CD8⁺was analyzed. Changes of CD3⁺, CD4⁺ and CD8⁺ levels in the infected group before and after treatment were analyzed. Results The levels of fasting blood glucose, 2 h postprandial blood glucose and HbA1c in the case group were significantly higher than those in the control group (9.24±0.89) mmol/L vs (4.81±0.63) mmol/L, (14.98±1.56) mmol/L vs (6.14±0.48) mmol/L, (7.47±0.89) % vs (4.05±0.35) % ] (（t=15.012,14.614,12.266,P<0.05) . The levels of fasting blood glucose, 2 h postprandial blood glucose and HbA1c in the infected group were higher than those in the uninfected group, but the differences were not statistically significant (P>0.05) . The levels of CD3⁺ and CD4+ levels in the infected group were lower than those in the uninfected group (60.32±2.14) % vs (65.57±2.53) %, (33.18±1.59) % vs (37.42±1.74)%] (t=11.596,13.237,P<0.05) , but there was no statistically significant difference in the level of CD8⁺between the two groups (P>0.05). Pearson correlation analysis showed that HbA1c was negatively correlated with CD3⁺ and CD4⁺ (r=-0.354,-0.512,P<0.05), and positively correlated with CD8⁺ (=0.336,P<0.05) . After treatment, CD3⁺ and CD4⁺ in the infected group were significantly increased, and the difference before and after treatment was statistically significant (t=9.518,8.217,P<0.01).Conclusions Patients with diabetes mellitus have elevated blood glucose level and decreased immunity. HbA1c is negatively correlated with CD3⁺ and CD4⁺, and positively correlated with CD8⁺.