摘要
目的研究维生素D对2型糖尿病并发泌尿系感染患者细胞免疫功能及预后的影响。方法选取2022年3月至2024年3月于新乡医学院第一附属医院就诊的100例2型糖尿病并发泌尿系感染患者进行研究,按随机数表法分为对照组和研究组各50例。两组患者均在常规的抗感染对症治疗的基础上实施后续治疗。对照组患者给予谷维素片治疗,研究组患者给予1α-羟基维生素D3(阿法骨化醇软胶囊)治疗,两组患者均治疗6个月。治疗后比较两组患者的临床疗效,以及治疗前及治疗6个月后的免疫球蛋白(IgA、IgG及IgM)、T细胞亚群(CD4^(+)/CD8^(+)、CD8^(+)、CD4^(+)及CD3^(+))水平、尿液菌落数量和25羟维生素D水平。结果治疗6个月后,研究组患者的治疗总有效率为94.00%,明显高于对照组的76.00%,差异有统计学意义(P<0.05)。治疗前及治疗6个月后,两组患者的免疫球蛋白水平比较差异均无统计学意义(P>0.05)。治疗前,两组患者的T细胞亚群比较差异无统计学意义(P>0.05);治疗6个月后,研究组患者的CD8^(+)水平为(15.59±2.39)%,明显低于对照组的(17.29±1.19)%,CD4^(+)/CD8^(+)、CD3^(+)、与CD4^(+)水平分别为1.56±0.16、(33.09±4.39)%、(59.59±6.79)%,明显高于对照组的1.38±0.15、(26.89±2.89)%、(54.39±5.19)%,差异均有统计学意义(P<0.05)。治疗前,两组患者尿液中菌落计数比较差异无统计学意义(P>0.05);治疗6个月后,两组患者尿液中菌落计数下降,且研究组为(80.45±14.36)个/mL,明显低于对照组的(120.46±12.57)个/mL,差异均有统计学意义(P<0.05)。治疗前,两组患者的25羟维生素D水平比较差异无统计学意义(P>0.05);治疗6个月后,两组患者的25羟维生素D水平上升,且研究组的25羟维生素D水平为(53.64±16.47)nmol/L,明显高于对照组的(44.28±15.25)nmol/L,差异均有统计学意义(P<0.05)。结论维生素D可明显提高2型糖尿病并发泌尿系感染患者的细胞免疫功能,改善预后。
Objective To investigate the effect of vitamin D on cellular immune function and prognosis in patients with type 2 diabetes mellitus(T2DM)complicated by urinary tract infection(UTI).Methods A total of 100 patients with T2DM complicated by UTI admitted to the First Affiliated Hospital of Xinxiang Medical University from March 2022 to March 2024 were selected and randomly divided into a control group and a study group(50 cases each).Both groups of patients received conventional anti-infective symptomatic treatment as baseline therapy.Patients in the control group were treated with oryzanol tablets,while those in the study group received 1α-hydroxyvitamin D3(alfacalcidol soft capsules),all for 6 months.After treatment,clinical efficacy was compared between the two groups,along with levels of immunoglobulins(IgA,IgG,IgM),T-cell subsets(CD4^(+)/CD8^(+),CD8^(+),CD4^(+),CD3^(+)),urinary bacterial colony counts,and 25-hydroxyvitamin D levels before and after 6 months of treatment.Results After 6 months of treatment,the total effective rate in the study group was 94.00%,significantly higher than 76.00%in the control group(P<0.05).Before and after treatment,there were no significant differences in immunoglobulin levels between the two groups(P>0.05).Before treatment,there were no significant differences in T-cell subsets between the two groups(P>0.05).After 6 months of treatment,the CD8^(+)level in the study group was(15.59±2.39)%,significantly lower than(17.29±1.19)%in the control group,while CD3^(+),CD4^(+)/CD8^(+),and CD4^(+)levels in the study group were 1.56±0.16,(33.09±4.39)%,and(59.59±6.79)%,respectively,significantly higher than 1.38±0.15,(26.89±2.89)%,and(54.39±5.19)%in the control group(P<0.05).Before treatment,there was no significant difference in urinary bacterial colony counts between the two groups(P>0.05).After 6 months of treatment,urinary bacterial colony counts decreased in both groups,with the study group showing significantly lower counts compared to the control group:(80.45±14.36)CFU/mL vs(120.46±12.57)CFU/mL,P<0.05.Before treatment,there was no significant difference in 25-hydroxyvitamin D levels between the two groups(P>0.05).After 6 months of treatment,25-hydroxyvitamin D levels increased in both groups,with the study group showing significantly higher levels than the control group:(53.64±16.47)nmol/L vs(44.28±15.25)nmol/L,P<0.05.Conclusion Vitamin D significantly improves cellular immune function and prognosis in patients with T2DM complicated by UTI.
作者
王旭
丰志鹏
覃艳
孟祥雨
徐云
白立炜
WANG Xu;FENG Zhi-peng;QIN Yan;MENG Xiang-yu;XU Yun;BAI Li-wei(Department of Endocrinology,the First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453100,Henan,CHINA;Department of General Practice 2,the First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453100,Henan,CHINA)
出处
《海南医学》
2025年第11期1545-1549,共5页
Hainan Medical Journal
基金
河南省医学科技攻关计划(联合共建)项目(编号:LHGJ20190461)。
关键词
2型糖尿病
泌尿系感染
细胞免疫
维生素D
预后
Type 2 diabetes
Urinary tract infection
Cellular immunity
Vitamin D
Prognosis
