儿童1型糖尿病T_H1/T_H2免疫应答状况研究  

Immune responses of T_H1/T_H2 in type 1 diabetic children

作　　者：支涤静[1] 王晓川[1] 沈水仙[1] 罗飞宏[1] 苏贻新[1] 方昕[1] 唐林妹 

机构地区：[1]复旦大学医学院儿科医院内分泌科,上海200032

出　　处：《中华儿科杂志》2001年第3期148-150,共3页Chinese Journal of Pediatrics

摘　　要：目的　研究儿童 1型糖尿病TH1 TH2免疫应答状况。方法　测定 30例儿童 1型糖尿病和 30例健康儿童的干扰素γ(IFN γ)、IL 4水平。根据不同病程、不同糖化血红蛋白 (HbA1c)水平及自身抗体的存在与否进行比较。结果　 1型糖尿病患儿的IFN γ水平高于对照组 ,但差异无显著性。其中病程 <2年者 ,IFN γ水平高于病程≥ 2年者 ,但差异无显著性。 1型糖尿病患儿的IL 4水平明显低于对照组 (P <0 0 1)。IFN γ IL 4比值明显高于对照组 (P <0 0 1)。HbA1 c <7 0 %、HbA1 c 7 0 %～9 0 %及HbA1 c>9 0 %的三组患儿作IFN γ、IL 4水平及IFN γ IL 4比值比较 ,差异无显著性。自身抗体阳性患儿和自身抗体阴性患儿的IFN γ、IL 4水平及IFN γ IL 4比值比较差异无显著性。结论　儿童 1型糖尿病存在TH1细胞免疫应答增强 ,TH2细胞免疫应答减弱 ,且这种特征在糖尿病发病早期表现得更突出。Objective To study the immune responses of T H1 and T H2 subsets of T cells in 30 children with type 1 diabetes mellitus. Methods The authors induced mononuclear cells to produce inteferon γ (IFN γ) and IL 4,and determined the IFN γ, IL 4 level with biotin avidin (BA) ELISA in 30 patients with type 1 diabetes mellitus and 30 healthy children. Comparisons were made between the two groups during the clinical course, in HbA1c and auto antibody levels. Results IFN γ level in type 1 diabetic children (1 917±1 187) ng/L was higher than that in normal subjects (1 507±494) ng/L, but the difference was not statistically significant. IFN γ level in patients with their clinical course < 2 years (2 126±1 230 ) ng/L was much higher than that of normal subjects ( P <0 01), and also higher tham that with ≥2 year clinical course (1 707±1 161) ng/L, which was not statistically significant. IL 4 of diabetic children (15±6) ng/L was significantly lower than that of normal subjects (109±26) ng/L ( P <0 01), and IFN γ/IL 4 ratio (138±100) was higher than those of normal subjects (16±8) ( P <0 01). The levels of IFN γ [(2 093±1 251 ) ng/L, (1 778±1 293 ) ng/L,(1 667±807 ) ng/L],IL 4 [(13 1±2 3 ) ng/L,(16±6) ng/L,(16±7)] ng/L and IFN γ/IL 4 ratio (159±96,123±108,117±80) among diabetic children with HbA1c<7 0%, HbA1c 7 0%～9 0% and HbA1c>9 0% respectively showed no difference. The levels of IFN γ [(2 009±1 047) ng/L, (1 766±1 316 ) ng/L], IL 4 [(14±4) ng/L, (17±6) ng/L] and IFN γ/IL 4 ratio (155±85, 120±109) between auto antibody positive and negative diabetic children also demonstrated no difference. Conclusion The data of this study suggest that T H1 responses increased and T H2 responses decreased in children with type 1 diabetes, especially in early stage of the disease.

关 键 词：儿童 Ⅰ型糖尿病 TH1细胞 TH2细胞 干扰素Ⅱ型 白细胞介素4 免疫应答 

分 类 号：R725.8[医药卫生—儿科]