CAJ | 학술논문

目的：研究糖尿病肺部感染患者免疫功能变化，为减少患者医院感染率提供理论依据。方法选取2012年1月－2014年6月收治的129例糖尿病患者，其中32例医院肺部感染，观察患者肺部感染后发生的免疫学变化及治疗后免疫学指标的改善。结果糖尿病肺部感染率为24．81％；感染组和未感染组的可溶性白介素‐2受体（SIL‐2 R）、G免疫球蛋白（IgG）、补体（C4）显著高于对照组，膜性白介素‐2受体（MIL‐2 R）、自然杀伤细胞（NK）活性、CD4＋／CD8＋显著低于对照组，差异有统计学意义（P＜0．01）；感染组的SIL‐2 R、NK活性显著高于未感染组，C4、CH50显著低于未感染组，差异有统计学意义（P＜0．01）；糖尿病医院肺部感染患者治疗后血糖和肺部感染均得到控制11例占34．38％，糖尿病肺部感染患者治疗后所有指标均较治疗前有所改善，差异有统计学意义（P＜ 0．01）；治疗后 SIL‐2R水平下降，MIL‐2R、NK 活性、CD4＋／CD8＋水平增加，差异有统计学意义（P＜0．01）。结论糖尿病患者肺部医院感染后免疫功能降低，通过对患者血糖的控制，能够降低患者肺部感染率。
목적：연구당뇨병폐부감염환자면역공능변화，위감소환자의원감염솔제공이론의거。방법선취2012년1월－2014년6월수치적129례당뇨병환자，기중32례의원폐부감염，관찰환자폐부감염후발생적면역학변화급치료후면역학지표적개선。결과당뇨병폐부감염솔위24．81％；감염조화미감염조적가용성백개소‐2수체（SIL‐2 R）、G면역구단백（IgG）、보체（C4）현저고우대조조，막성백개소‐2수체（MIL‐2 R）、자연살상세포（NK）활성、CD4＋／CD8＋현저저우대조조，차이유통계학의의（P＜0．01）；감염조적SIL‐2 R、NK활성현저고우미감염조，C4、CH50현저저우미감염조，차이유통계학의의（P＜0．01）；당뇨병의원폐부감염환자치료후혈당화폐부감염균득도공제11례점34．38％，당뇨병폐부감염환자치료후소유지표균교치료전유소개선，차이유통계학의의（P＜ 0．01）；치료후 SIL‐2R수평하강，MIL‐2R、NK 활성、CD4＋／CD8＋ 수평증가，차이유통계학의의（P＜0．01）。결론당뇨병환자폐부의원감염후면역공능강저，통과대환자혈당적공제，능구강저환자폐부감염솔。
OBJECTIVE To observe the change of immune function of the diabetic mellitus patients complicated with pulmonary infections so as to provide theoretical basis for reduction of incidence of nosocomial infections . METHODS A total of 129 diabetic mellitus patients who were treated in the hospital from Jan 2012 to Jun 2014 were enrolled in the study ,including 32 cases of pulmonary infections .The immunological changes of the patients with pulmonary infections were analyzed ,and the immunological indicators were observed after the treatment . RESULTS The incidence of pulmonary infections was 24 .81% in the patients with diabetic mellitus .The levels of soluble interleukin‐2 receptor (SIL‐2 R) ,immunoglobulin G (IgG) ,and complement (C4 ) of the infection group and the non‐infection group were significantly higher than those of the control group ;the membranous interleukin‐2 receptor (MIL‐2 R) ,activity of natural killer (NK) cell ,and CD4 + /CD8 + of the infection group and the non‐in‐fection group were significantly lower than those of the control group ,and there was statistically significant differ‐ence (P<0 .01);the SIL‐2 R and activity of NK cell of the infection group were significantly higher than those of the non-infection group ,and the levels of C4 and CH50 of the infection group were significantly lower than those of the non-infection group ,with statistical significance (P<0 .01) .The blood glucose and pulmonary infections of 11 (34 .38% ) diabetic mellitus patients have been controlled after the treatment of pulmonary infections ,and all the indicators of the diabetic mellitus patients with pulmonary infections were significantly improved after the treatment ,as compared with those before the treatment ,and there was statistically significant difference (P<0 .01) .After the treatment ,the level of SIL‐2R was reduced ,while the MIL‐2 R ,activity of NK cell ,and CD4 + /CD8 + were elevated ,and there was statistically significant difference (P< 0 .01) .CONCLUSION The immune function of the diabetic mellitus patients complicated with pulmonary infections is reduced ,and the control of the blood glucose may contribute to the reduction of incidence of the pulmonary infections .