摘要
目的:探讨脾虚痰湿型2型糖尿病(type 2diabetes mellitus,T2DM)患者Th1/Th2细胞亚群漂移及其比例变化与糖代谢指标的关系.方法:共入选45例T2DM患者,根据中医症候分型分为脾虚痰湿组(23例)与非脾虚痰湿组(22例)2组,另招募20例健康者作为正常对照组,观察各组空腹血糖(fasting bloodglucose,FBG)及糖化血红蛋白(glycosylated hemoglobin,Hb Alc)等糖代谢相关指标,同时采用流式细胞仪单克隆免疫荧光法检测CD4+T细胞亚群Th1、Th2的细胞比率,并对Th1/Th2比值与糖代谢相关指标进行相关性分析.结果:脾虚痰湿型T2DM组的Th1细胞比率、T h1/T h2比值明显高于非脾虚痰湿T2D M组及正常对照组(均P<0.05);Th2细胞比率明显低于正常对照组(P<0.05),但与非脾虚痰湿型T2DM组相比差异无统计学意义.相关分析结果显示,脾虚痰湿型T2DM组的Th1细胞比率及Th1/Th2比值均分别与FBG、Hb A1c呈显著正相关(r=0.898、0.678;0.869、0.630),而Th2细胞比率与FBG、Hb A1c未见明显相关关系.非脾虚痰湿型T2DM组Th1细胞比率及Th1/Th2比值均分别与FBG、Hb A1c亦呈正相关(r=0.751、0.589;0.658、0.545),而Th2细胞比率与FBG、Hb A1c未见明显相关关系.结论:T2DM患者体内均存在明显的Th1/T h2细胞比率失衡且与糖代谢紊乱严重程度明显相关,在脾虚痰湿型患者中这种变化尤为显著.改变T2DM患者的细胞免疫学特点可能是脾虚痰湿加重T2DM的作用机制之一.
AIM：To explore the relationship between the changes of drift and proportion of Th1/Th2 cell subsets and glucose metabolism in type 2diabetes mellitus（T2DM） patients with spleendeficiency and phlegm stagnation syndrome.METHODS：According to traditional Chinese medicine（TCM） syndrome classification,45 type 2 diabetic patients were divided into a spleen-deficiency and phlegm stagnation syndrome group（23 cases） and a non-spleendeficiency and phlegm stagnation syndrome group（22 cases）.Meanwhile,20 healthy subjects were recruited as a normal control group（NC group）.Glycometabolic indexes such as fasting blood glucose（FBG） and glycosylated hemoglobin（HbA1c） were observed.Th1 and Th2 cell proportions and Thl/Th2 ratio in CD4~＋ T-cell subsets were determined by flow cytometry using monoclonal immunofluorescence method.The relationship between Th1/Th2 ratio and glycometabolic indexes was analyzed.RESULTS：Th1 cell proportion and Th1/Th2 ratio were both significantly increased in the spleen-deficiency and phlegm stagnation syndrome group compared with the nonspleen-deficiency and phlegm stagnation syndrome group and NC group（P 〈 0.05）.Th2 cell proportion was significantly decreased in the spleen-deficiency and phlegm stagnation syndrome group compared with the NC group（P 〈 0.05）,although there was no significant difference between the two T2DM groups.Correlation analysis showed that Th1 cell proportion and Thl/Th2 ratio both had a significant correlation with FBG,and HbA1c（r=0.898,0.678;0.869,0.630） in spleen-deficiency and phlegm stagnation syndrome T2 DM group,but there was no correlation between Th2 cell proportion and FBG or HbAlc.The similar results were obtained in the non-spleendeficiency and phlegm stagnation syndrome group.Thl cell proportion and Th1/Th2 ratio both had a significant correlation with FBG and HbAlc（r = 0.751,0.589;0.658,0.545）,and there was no correlation between Th2 cell proportion and FBG or HbAlc.CONCLUSION：There is obvious Thl/Th2 imbalance in T2DM patients,and the imbalance correlates with the severity of glycometabolic disturbance,which is especially significant in T2DM patients with spleen-deficiency and phlegm stagnation syndrome.Altered cell immunological characteristics in T2 DM patients may be one of the mechanisms by which spleen deficiency aggravates T2DM.
出处
《世界华人消化杂志》
CAS
2015年第5期876-880,共5页
World Chinese Journal of Digestology
基金
广东省中医药管理局基金资助项目
No.粤中医20131193号
广东省自然科学基金资助项目
No.S2013040013379~~
关键词
2型糖尿病
流式细胞术
糖代谢
T细胞亚群
脾虚痰湿
Type 2 diabetes mellitus
Flow cytometry
Giycometaboiism
T-lymphocyte subsets
Spleen-deficiency and phlegm stagnation syndrome
