中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2013年
13期
8-11
,共4页
糖尿病%结核,肺%可溶性凋亡相关因子%可溶性凋亡相关因子配体
糖尿病%結覈,肺%可溶性凋亡相關因子%可溶性凋亡相關因子配體
당뇨병%결핵,폐%가용성조망상관인자%가용성조망상관인자배체
Diabetes mellitus%Tuberculosis,pulmonary%Soluble apoptosis related factor%Soluble apoptosis related factor ligands
目的 探讨糖尿病并发肺结核患者外周血可溶性Fas(sFas)和可溶性FasL(sFasL)变化,以期为糖尿病并发肺结核的病情判断及干预治疗提供依据.方法 选取糖尿病并发肺结核(糖尿病并发肺结核组)、单纯糖尿病(糖尿病组)、单纯肺结核(肺结核组)、健康体检者(对照组)各25例,以酶联免疫吸附试验法检测外周血sFas和sFasL及T淋巴细胞亚群水平.结果 糖尿病并发肺结核组、糖尿病组、肺结核组外周血sFas及sFasL水平明显高于对照组[(7.91±1.93)、(8.74±2.12)、(7.86± 1.61) mg/L比(2.10±0.88) mg/L和(562.37±196.38)、(1512.32±303.48)、(607.48±102.53) ng/L比(263.18±46.32) ng/L] (P＜ 0.05),糖尿病组外周血sFas及sFasL水平高于糖尿病并发肺结核组、肺结核组(P＜0.05),sFasL以1000 ng/L为分界值,糖尿病并发肺结核组及糖尿病组合计诊断符合率为90.00％(45/50);糖尿病并发肺结核组、糖尿病组、肺结核组CD3+、CD4+T淋巴细胞明显低于对照组(0.3376±0.0712、0.2368±0.0803、0.4801±0.0896比0.5849±0.0487和0.1798±0.0401、0.2100±0.0679、0.2312±0.0487比0.2811±0.0348)(P＜0.05),糖尿病并发肺结核组CD3+T淋巴细胞高于糖尿病组、低于肺结核组(P＜0.05),糖尿病并发肺结核组CD4+T淋巴细胞明显低于糖尿病组及肺结核组(P＜0.05),糖尿病并发肺结核组、糖尿病组CD8+T淋巴细胞高于对照组(0.3209±0.0707、0.2831±0.0794比0.2086±0.0589)(P＜0.05),糖尿病并发肺结核组CD8+T淋巴细胞高于糖尿病组及肺结核组(0.2287±0.0690) (P＜ 0.05)；糖尿病并发肺结核组、糖尿病组、肺结核组CD3+、CD4+、CD8+T淋巴细胞凋亡率高于对照组[(4.34±2.08)％、(3.22±2.12)％、(2.59±1.41)％比(1.01±0.38)％,(5.12±1.58)％、(4.82±1.98)％、(3.21±1.19)％比(1.78±0.53)％和(1.45±0.52)％、(2.31±2.01)％、(1.62±1.33)％比(1.07±0.38)％](P＜0.05),糖尿病并发肺结核组、糖尿病组CD3+、CD4+T淋巴细胞凋亡率高于肺结核组(P＜0.05),糖尿病组CDs+T淋巴细胞凋亡率高于肺结核组(P＜0.05).结论 糖尿病并发肺结核患者外周血sFas及sFasL存在异常升高,CD3+、CD4+T淋巴细胞降低,提示患者存在免疫功能失调,sFas及sFasL可能参与了疾病的发生及发展过程,外周血sFasL含量还可作为鉴别糖尿病患者是否并发肺结核的辅助诊断指标.
目的 探討糖尿病併髮肺結覈患者外週血可溶性Fas(sFas)和可溶性FasL(sFasL)變化,以期為糖尿病併髮肺結覈的病情判斷及榦預治療提供依據.方法 選取糖尿病併髮肺結覈(糖尿病併髮肺結覈組)、單純糖尿病(糖尿病組)、單純肺結覈(肺結覈組)、健康體檢者(對照組)各25例,以酶聯免疫吸附試驗法檢測外週血sFas和sFasL及T淋巴細胞亞群水平.結果 糖尿病併髮肺結覈組、糖尿病組、肺結覈組外週血sFas及sFasL水平明顯高于對照組[(7.91±1.93)、(8.74±2.12)、(7.86± 1.61) mg/L比(2.10±0.88) mg/L和(562.37±196.38)、(1512.32±303.48)、(607.48±102.53) ng/L比(263.18±46.32) ng/L] (P＜ 0.05),糖尿病組外週血sFas及sFasL水平高于糖尿病併髮肺結覈組、肺結覈組(P＜0.05),sFasL以1000 ng/L為分界值,糖尿病併髮肺結覈組及糖尿病組閤計診斷符閤率為90.00％(45/50);糖尿病併髮肺結覈組、糖尿病組、肺結覈組CD3+、CD4+T淋巴細胞明顯低于對照組(0.3376±0.0712、0.2368±0.0803、0.4801±0.0896比0.5849±0.0487和0.1798±0.0401、0.2100±0.0679、0.2312±0.0487比0.2811±0.0348)(P＜0.05),糖尿病併髮肺結覈組CD3+T淋巴細胞高于糖尿病組、低于肺結覈組(P＜0.05),糖尿病併髮肺結覈組CD4+T淋巴細胞明顯低于糖尿病組及肺結覈組(P＜0.05),糖尿病併髮肺結覈組、糖尿病組CD8+T淋巴細胞高于對照組(0.3209±0.0707、0.2831±0.0794比0.2086±0.0589)(P＜0.05),糖尿病併髮肺結覈組CD8+T淋巴細胞高于糖尿病組及肺結覈組(0.2287±0.0690) (P＜ 0.05)；糖尿病併髮肺結覈組、糖尿病組、肺結覈組CD3+、CD4+、CD8+T淋巴細胞凋亡率高于對照組[(4.34±2.08)％、(3.22±2.12)％、(2.59±1.41)％比(1.01±0.38)％,(5.12±1.58)％、(4.82±1.98)％、(3.21±1.19)％比(1.78±0.53)％和(1.45±0.52)％、(2.31±2.01)％、(1.62±1.33)％比(1.07±0.38)％](P＜0.05),糖尿病併髮肺結覈組、糖尿病組CD3+、CD4+T淋巴細胞凋亡率高于肺結覈組(P＜0.05),糖尿病組CDs+T淋巴細胞凋亡率高于肺結覈組(P＜0.05).結論 糖尿病併髮肺結覈患者外週血sFas及sFasL存在異常升高,CD3+、CD4+T淋巴細胞降低,提示患者存在免疫功能失調,sFas及sFasL可能參與瞭疾病的髮生及髮展過程,外週血sFasL含量還可作為鑒彆糖尿病患者是否併髮肺結覈的輔助診斷指標.
목적 탐토당뇨병병발폐결핵환자외주혈가용성Fas(sFas)화가용성FasL(sFasL)변화,이기위당뇨병병발폐결핵적병정판단급간예치료제공의거.방법 선취당뇨병병발폐결핵(당뇨병병발폐결핵조)、단순당뇨병(당뇨병조)、단순폐결핵(폐결핵조)、건강체검자(대조조)각25례,이매련면역흡부시험법검측외주혈sFas화sFasL급T림파세포아군수평.결과 당뇨병병발폐결핵조、당뇨병조、폐결핵조외주혈sFas급sFasL수평명현고우대조조[(7.91±1.93)、(8.74±2.12)、(7.86± 1.61) mg/L비(2.10±0.88) mg/L화(562.37±196.38)、(1512.32±303.48)、(607.48±102.53) ng/L비(263.18±46.32) ng/L] (P＜ 0.05),당뇨병조외주혈sFas급sFasL수평고우당뇨병병발폐결핵조、폐결핵조(P＜0.05),sFasL이1000 ng/L위분계치,당뇨병병발폐결핵조급당뇨병조합계진단부합솔위90.00％(45/50);당뇨병병발폐결핵조、당뇨병조、폐결핵조CD3+、CD4+T림파세포명현저우대조조(0.3376±0.0712、0.2368±0.0803、0.4801±0.0896비0.5849±0.0487화0.1798±0.0401、0.2100±0.0679、0.2312±0.0487비0.2811±0.0348)(P＜0.05),당뇨병병발폐결핵조CD3+T림파세포고우당뇨병조、저우폐결핵조(P＜0.05),당뇨병병발폐결핵조CD4+T림파세포명현저우당뇨병조급폐결핵조(P＜0.05),당뇨병병발폐결핵조、당뇨병조CD8+T림파세포고우대조조(0.3209±0.0707、0.2831±0.0794비0.2086±0.0589)(P＜0.05),당뇨병병발폐결핵조CD8+T림파세포고우당뇨병조급폐결핵조(0.2287±0.0690) (P＜ 0.05)；당뇨병병발폐결핵조、당뇨병조、폐결핵조CD3+、CD4+、CD8+T림파세포조망솔고우대조조[(4.34±2.08)％、(3.22±2.12)％、(2.59±1.41)％비(1.01±0.38)％,(5.12±1.58)％、(4.82±1.98)％、(3.21±1.19)％비(1.78±0.53)％화(1.45±0.52)％、(2.31±2.01)％、(1.62±1.33)％비(1.07±0.38)％](P＜0.05),당뇨병병발폐결핵조、당뇨병조CD3+、CD4+T림파세포조망솔고우폐결핵조(P＜0.05),당뇨병조CDs+T림파세포조망솔고우폐결핵조(P＜0.05).결론 당뇨병병발폐결핵환자외주혈sFas급sFasL존재이상승고,CD3+、CD4+T림파세포강저,제시환자존재면역공능실조,sFas급sFasL가능삼여료질병적발생급발전과정,외주혈sFasL함량환가작위감별당뇨병환자시부병발폐결핵적보조진단지표.
Objective To explore the changes of the peripheral blood soluble Fas (sFas) and soluble FasL (sFasL) in patients of diabetes complicated with tuberculosis,in order to provide the basis for condition judgment and intervention.Methods The patients of diabetes complicated with tuberculosis (diabetes comphcated with tuberculosis group,25 cases),simple diabetes (diabetes group,25 cases),simple tuberculosis (tuberculosis group,25 cases) and healthy person (control group,25 cases) were selected.The peripheral blood sFas,sFasL and T-lymphocyte subsets were examined by enzyme-linked immunosorbent test.Results The peripheral blood sFas,sFasL in diabetes complicated with tuberculosis group,diabetes group,tuberculosis group was higher than that in control group[(7.91 ± 1.93),(8.74 ± 2.12),(7.86 ± 1.61)mg/L vs.(2.10 ±0.88) mg/L and (562.37 ± 196.38),(1512.32 ±303.48),(607.48 ± 102.53) ng/L vs.(263.18 ±46.32) ng/L](P＜ 0.05).The peripheral blood sFas,sFasL in diabetes group was higher than that in diabetes complicated with tuberculosis group and tuberculosis group (P ＜ 0.05).With sFasL 1000 ng/L as boundary value,the diagnostic coincidence rate of diabetes complicated with tuberculosis group and diabetes group was 90.00％ (45/50).CD3 +,CD4+ T-lymphocyte subsets in diabetes complicated with tuberculosis group,diabetes group,tuberculosis group was lower than that in control group (0.3376 ± 0.0712,0.2368 ± 0.0803,0.4801 ± 0.0896 vs.0.5849 ± 0.0487 and 0.1798 ± 0.0401,0.2100 ± 0.0679,0.2312 ± 0.0487 vs.0.2811 ± 0.0348) (P ＜ 0.05).CD3 + T-lymphocyte subsets in diabetes complicated with tuberculosis group was higher than that in diabetes group and lower than that in tuberculosis group (P ＜ 0.05).CD4+ T-lymphocyte subsets in diabetes complicated with tuberculosis group was lower than that in diabetes group,tuberculosis group(P ＜ 0.05).CD8+ T-lymphocyte subsets in diabetes complicated with tuberculosis group,diabetes group was higher than that in control group (0.3209 ± 0.0707,0.2831 ± 0.0794 vs.0.2086 ± 0.0589)(P ＜ 0.05).CD8+ T-lymphocyte subsets in diabetes complicated with tuberculosis group was higher than that in diabetes group and tuberculosis group (0.2287 ± 0.0690)(P ＜ 0.05).C D3 +,CD4+,CD8+ T-lymphocyte apoptotic rate in diabetes complicated with tuberculosis group,diabetes group,tuberculosis group was higher than that in control group [(4.34 ± 2.08)％,(3.22 ± 2.12)％,(2.59 ± 1.41)％ vs.(1.01 ± 0.38)％,(5.12 ± 1.58)％,(4.82 ± 1.98)％,(3.21 ± 1.19)％ vs.(1.78 ±0.53)％ and (1.45 ±0.52)％,(2.31 ±2.01)％,(1.62 ± 1.33)％ vs.(1.07 ± 0.38)％] (P ＜ 0.05).CD3 +,CD4+ T-lymphocyte apoptotic rate in diabetes complicated with tuberculosis group,diabetes group was higher than that in tuberculosis group (P ＜0.05).CD8+ Tlymphocyte apoptotic rate in diabetes group was higher than that in tuberculosis group (P ＜ 0.05).Conclusions The peripheral blood sFas and sFasL exists abnormal increase in patients of diabetes complicated with tuberculosis.CD3+,CD4+ T-lymphocyte decreasing shows that the patients exist immune function disorder.sFas and sFasL may be involved development process of disease,and the peripheral blood sFasL content can also be used as auxiliary indicators for identifying diabetes patients with tuberculosis.
