摘要
目的 从免疫功能变化探讨糖尿病患者肺部感染的防治。方法 动态观测糖尿病及其合并肺部感染患者治疗前后可溶性白细胞介素 2受体 (SIL 2R)、膜性白细胞介素 2受体 (mIL 2R)、自然杀伤细胞 (NK)活性、CD4 /CD8、IgG、IgA、IgM、C3、C4 、CH50 等免疫指标的变化。结果 (1)糖尿病及其合并肺部感染组SIL 2R显著高于正常对照组 (P <0 .0 1) ,mIL 2R、NK细胞活性、CD4 /CD8显著低于正常对照组 (P <0 .0 5 ) ;(2 )糖尿病合并肺部感染患者治疗期间 ,随着空腹血糖、餐后 2小时血糖 (BG2h)降低及感染的好转 ,SIL 2R逐渐下降 ,mIL 2R、NK活性、CD4 /CD8逐渐升高 ,且SIL 2R与BG2h呈显著正相关 (r=0 .5 83,P <0 .0 5 ) ,mIL 2R、CD4 /CD8与BG2h呈显著负相关 (r分别为 - 0 .5 46和 - 0 .5 76 ,P均 <0 .0 5 ) ;(3)当糖尿病组血糖得到控制 ,肺部感染组感染治愈时 ,其SIL 2R、mIL 2R、NK细胞活性、CD4 /CD8均可恢复至近于正常范围。结论 (1)糖尿病合并肺部感染患者因血糖的升高而存在机体免疫功能下降 ,降低血糖特别是BG2h有助于免疫功能的恢复 ,有效地防治肺部感染的发生和发展 ;(2 )糖尿病合并肺部感染可加重糖尿病及机体免疫功能的低下 ,故积极抗感染同样重要。
Objective To investigate the effects of prevention and treatment of pneumonia in diabetics on the disturbances of immune function. Methods The changes of serum soluble interleukin 2 receptor (SIL 2R)、 membrane interleukin 2 receptor (mIL 2R), IgG, IgM, IgA, C 3, C 4, CH 50 , and natural killer (NK) cell activity. CD 4/CD 8 were dynamically observed before and after treatment in 30 diabetic patients with pneumonia and 32 uncomplicated diabetic patients. Results (1)SIL 2R in diabetic patients and diabetic patients with pneumonia were higher, and mIL 2R, NK cell activity as well as CD 4/CD 8 were lower than those in normal control group (P<0.05). (2)When the diabetic patients with pneumonia were treated, fasting blood glucose, postprandial 2h blood glucose (BG2h) and SIL 2R decreased while mIL 2R, NK cell activity, CD 4/CD 8 increased gradually. SIL 2R exhibited a significantly postive linear correlation with BG2h (r=0.583, P<0.05), mIL 2R、 CD 4/CD 8 exhibited a significantly negative linear correlation with BG2h (r=-0.546 and -0.576 respectively P<0.05). (3)When diabetic patients with pneumonia was controlled, and pneumonia was cured, abnormality of their SIL 2R, mIL 2R, NK cell activity、 CD 4/CD 8 reversed to normal range. Conclusions (1)The diabetic patients exist a decline of host immunity because of hyperglycemia. Reducing hyperglycemia, especially BG2h will help to recover the host immune function, prevent or treat pneumonia efficaciously. (2)Pneumonia may depress the host immunity in diabetic patients, suggesting the importance of infection control in diabetics.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2000年第5期288-291,共4页
Chinese Journal of Endocrinology and Metabolism
基金
广东省医药卫生青年科学研究基金资助项目!(粤卫科1996 19)
关键词
糖尿病
肺部感染
免疫功能
防治
Diabetes mellitus
Pulmonary infection
Immune
