糖尿病免疫发病机制的临床研究  

The Clinical Study on Immunopathogenesis of Diabetes Mellitus

作　　者：林永丽[1] 石琳琳[1] 邵红[1] 吴晓萍[1] 曹桂莲[1] 

机构地区：[1]吉林省人民医院,吉林长春130021

出　　处：《中国实验诊断学》2005年第6期941-943,共3页Chinese Journal of Laboratory Diagnosis

摘　　要：目的本研究检测了初发的DM1,DM2,LADA患者体内GAD-Ab,T淋巴细胞亚群以及细胞因子(TNF-浕,SIL-2R,NO)的变化情况,旨在探讨免疫因素在各型糖尿病发病机制中所起的作用。研究发现,DM1组GAD-Ab,CD4+T淋巴细胞,CD4+与CD8+T淋巴细胞之比,以及TNF-浕,NO,SIR-2D的水平明显高于对照组,LADA组上述指标的变化有相同的趋势。而DM2组则无上述变化。在DM1组及LADA组,GAD-Ab,与CD4+/CD8+T淋巴细胞亚群,TNF-浕的水平正相关,NO与TNF-浕水平正相关,而DM2组及正常对照组无上述变化。本研究得出以下结论:DM1及LADA的发病均有自身免疫机制的参与,而DM2的发病与自身免疫不密切:GAD抗原的暴露为自身免疫性糖尿病重要的启动因素,在临床上可以通过检测GAD-Ab来帮助糖尿病分型,进而指导临床治疗。Objective Changes of GAD-AbmT lymphocyte subpopulation and cytokine（TNF-α, SIL-2R, NO）in early period of DM1, DM2 or LADA were found in this study and the relationsip between these changes were analysed in order to research the immu- nopathogenesis of DM. The results demonstrated as follows （ l ） concentration of GAD-Ab, CD4 ^＋ T lymphocyte, ration of CD4 ^＋ to CD8^＋ T lymphocyte subpopulation, TNF-α, NO and SIL-2R were higher in patients with DM1 and LADA than those in eontrons group, well singnificant difference were not in in patients with DM2 （2）Concentration of GAD-Ab had the positive correlation with the concentration of TNF-α and the ration of CD4 ^＋ to CD8^＋ T lymphocyte subpopulation （3）Concentration of NO was related positiviy with that of TNF-α. According to results above, here comes the follwing. Conclusions （1）Autommune progress accelerate the occurrence of DM 1 and LADA ： （2） GA is an important initiator to the occurrence of autoimmune DM ： （3） Assay of concentration of GAD- Ab may be caluable to distinguish the subtypes of DM.

关 键 词：糖尿病 免疫 谷氨酸脱羧酶抗体 T淋巴细胞亚群 一氧化碳 肿瘤坏死因子 白细胞介素-2受体 

分 类 号：R587.1[医药卫生—内分泌]