糖尿病合并社区获得性肺炎患者血浆CD4~+、CD4~+CD25~+调节性T细胞变化的临床意义

目的:探讨糖尿病合并社区获得性肺炎患者血浆CD4+、CD4+CD25+调节性T细胞的变化及临床意义。方法:选择糖尿病合并社区获得性肺炎患者62例为观察组,入院后进行相关降糖及抗感染治疗,观察患者入院时、入院治疗8周后血浆CD4+、CD4+CD25+T细胞水平,并探讨其与血糖控制水平的关系。另选择30例健康体检者为对照组。结果:治疗前后,观察组血浆CD4+细胞水平显著低于健康对照组,CD4+CD25+及CD4+CD25+/CD4+比值高于对照组(P<0.05或P<0.01)。与治疗前比较,治疗8周后观察组CD4+细胞水平升高(P<0.05),CD4+CD25+及CD4+CD25+/CD4+比值显著降低(P<0.01)。观察组依据治疗效果分为治愈组、有效组及无效组,CD4+水平随疗效的增加而增加,CD4+CD25+水平及CD4+CD25+/CD4+比值随疗效的增加而降低,3组比较差异具有统计学意义(P<0.05)。CD4+T细胞水平与餐后2 h血糖(2 h PBG)水平呈显著负相关(r=-0.522,P<0.05)。结论:检测CD4+T细胞、CD4+CD25+调节性T细胞变化,可客观评价糖尿病合并社区获得性肺炎患者免疫功能。

Clinical significance of plasma CD4 + cell and CD4 + CD25 + regulatory T cell changes in patients with diabetes mellitus combined with CAP

Objective:To explore the changes of plasma CD4 +、CD4 +CD25 + regulatory T cells and their significance in pa-tients with diabetes mellitus combined with community-acquired pneumonia (CAP).Methods:A total of 62 patients with diabetes mel-litus combined with CAP were selected as observation group and treated with corresponding hypoglycemic and anti-infection treatment after being hospitalized.Plasma CD4 +、CD4 +CD25 +T cell levels before hospitalization and 8 weeks after treatment were observed to explore their relationship with controlling level of blood sugar.And another 30 healthy examiners served as control group.Results:Be-fore and after hospitalization,observation group was evidently lower in observation group CD4 + cell level than control group,but markedly higher in CD4 +CD25 + and CD4 +CD25 + /CD4 + ratio than control group (P <0.05,P <0.01 ).Compared with treatment before,8 weeks after hospitalization,CD4 + cell level increased obviously (P <0.05 )while CD4 +CD25 + and CD4 +CD25 + /CD4 +ratio decreased significantly in observation group (P <0.01 ).Observation group was divided into recovery group,effective group and non-effective group,according to therapeutic efficacy.CD4 + cell level increased while CD4 +CD25 + and CD4 +CD25 + /CD4 + ratio decreased along with efficacy,and there were significant differences among 3 groups (P <0.05).And CD4 + cell level was in negative association with plasma blood glucose level 2 h after meal (2 h PBG)(r =-0.522,P <0.05).Conclusion:Detecting CD4 + cell lev-el and CD4 +CD25 + regulatory T cell changes can objectively evaluate the immunological function of patients with diabetes mellitus combined with CAP.