CAJ | 학술논문

目的研究儿童1型糖尿病TH1/TH2免疫应答状况。方法测定30例儿童1型糖尿病和30例健康儿童的干扰素γ（IFN-γ）、IL-4水平。根据不同病程、不同糖化血红蛋白（HbA1c）水平及自身抗体的存在与否进行比较。结果1型糖尿病患儿的IFN-γ水平高于对照组，但差异无显著性。其中病程＜2年者，IFN-γ水平高于病程≥2年者，但差异无显著性。1型糖尿病患儿的IL-4水平明显低于对照组（P<0.01）。IFN-γ/IL-4比值明显高于对照组（P<0.01）。HbA1-c＜7.0%、HbA1-c7.0%～9.0%及HbA1-c＞9.0%的三组患儿作IFN-γ、IL-4水平及IFN-γ/IL-4比值比较，差异无显著性。自身抗体阳性患儿和自身抗体阴性患儿的IFN-γ、IL-4水平及IFN-γ/IL-4比值比较差异无显著性。结论儿童1型糖尿病存在TH1细胞免疫应答增强，TH2细胞免疫应答减弱，且这种特征在糖尿病发病早期表现得更突出。
목적연구인동1형당뇨병TH1/TH2면역응답상황。방법측정30례인동1형당뇨병화30례건강인동적간우소γ（IFN-γ）、IL-4수평。근거불동병정、불동당화혈홍단백（HbA1c）수평급자신항체적존재여부진행비교。결과1형당뇨병환인적IFN-γ수평고우대조조，단차이무현저성。기중병정＜2년자，IFN-γ수평고우병정≥2년자，단차이무현저성。1형당뇨병환인적IL-4수평명현저우대조조（P<0.01）。IFN-γ/IL-4비치명현고우대조조（P<0.01）。HbA1-c＜7.0%、HbA1-c7.0%～9.0%급HbA1-c＞9.0%적삼조환인작IFN-γ、IL-4수평급IFN-γ/IL-4비치비교，차이무현저성。자신항체양성환인화자신항체음성환인적IFN-γ、IL-4수평급IFN-γ/IL-4비치비교차이무현저성。결론인동1형당뇨병존재TH1세포면역응답증강，TH2세포면역응답감약，차저충특정재당뇨병발병조기표현득경돌출。
Objective To study the immune responses of TH1 and TH2 subsets ofT cells in 30 children with type 1 diabetes mellitus. Methods The authors induced mononuclear cells to produce inteferon-γ (IFN-γ) and IL-4，and determined the IFN-γ, IL-4 level with biotin-avidin (BA)-ELISA in 30 patients with type 1 diabetes mellitus and 30 healthy children. Comparisons were made between the two groups during the clinical course, in HbA1c and auto antibody levels. Results IFN-γ level in type 1 diabetic children (1 917±1 187) ng/L was higher than that in normal subjects (1 507±494) ng/L, but the difference was not statistically significant. IFN-γ level in patients with their clinical course < 2 years (2 126±1 230 ) ng/L was much higher than that of normal subjects (P＜0.01), and also higher tham that with ≥2-year clinical course (1 707±1 161) ng/L, which was not statistically significant. IL-4 of diabetic children (15±6) ng/L was significantly lower than that of normal subjects (109±26) ng/L (P<0.01), and IFN-γ/IL-4 ratio (138±100) was higher than those of normal subjects (16±8) (P<0.01). The levels of IFN-γ [(2 093±1 251 ) ng/L, （1 778±1 293 ） ng/L,（1 667±807 ） ng/L]，IL-4 [(13.1±2.3 ) ng/L,（16±6） ng/L,（16±7）] ng/L and IFN-γ/IL-4 ratio (159±96,123±108,117±80) among diabetic children with HbA1c<7.0%, HbA1c 7.0%～9.0% and HbA1c>9.0% respectively showed no difference. The levels of IFN-γ [(2 009±1 047) ng/L, （1 766±1 316 ） ng/L], IL-4 [(14±4) ng/L, (17±6) ng/L] and IFN-γ/IL-4 ratio (155±85, 120±109) between auto antibody positive and negative diabetic children also demonstrated no difference. Conclusion The data of this study suggest that TH1 responses increased and TH2 responses decreased in children with type 1 diabetes, especially in early stage of the disease.