外周血CD4^+CD25^+调节性T淋巴细胞对增殖性糖尿病视网膜病的临床指导价值  

The clinical value of peripheral blood CD4^+CD25^+ T cells on patients with proliferative diabetic retinopathy

作　　者：龚珂[1] 孙文涛[1] 吕伯昌[1] 王欣荣[1] 陈涛[1] 

机构地区：[1]陕西省眼科医疗中心眼科西安市第四医院眼科西安交通大学附属广仁医院眼科,陕西西安710004

出　　处：《中国医药导报》2015年第33期17-20,共4页China Medical Herald

基　　金：国家自然科学基金资助项目(81273902)

摘　　要：目的探讨外周血CD4+CD25+T细胞(Treg细胞)在增殖性糖尿病视网膜病(PDR)患者中的表达意义。方法选取2014年6月~2015年5月西安市第四医院收治的玻璃体积血糖尿病视网膜病患者42例(PDR组)和2型糖尿病无PDR患者30例(糖尿病组),同时选取健康志愿者30例(正常对照组),采用流式细胞仪检测各组患者外周血Treg细胞比例,同时检测各组患者糖化血红蛋白(Hb A1c)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、血清肌酐(Scr)和尿素氮(BUN)水平。结果 PDR组、糖尿病组和正常对照组年龄、性别比较差异无统计学意义(P>0.05);PDR组Hb A1c、TG、BUN分别为(8.02±2.53)%、(2.01±1.04)mmol/L和(7.88±1.43)mmol/L,明显高于正常对照组的(4.92±1.38)%、(0.94±0.24)mmol/L和(3.45±1.25)mmol/L,差异有统计学意义(P<0.05);PDR组TC、LDL-C和Scr分别为(5.44±1.21)mmol/L、(3.78±1.06)mmol/L和(118.63±34.16)μmol/L,明显高于糖尿病组的(4.47±1.33)mmol/L、(2.91±1.18)mmol/L和(88.63±23.21)μmol/L及正常对照组的(3.08±1.12)mmol/L、(1.60±0.82)mmol/L和(61.32±17.21)μmol/L,差异均有统计学意义(均P<0.05),而HDL-C为(1.22±0.34)mmol/L,低于正常对照组的(4.26±1.33)mmol/L,差异有统计学意义(P<0.05);PDR组患者外周血CD4+T细胞比例为(18.21±5.34)%,明显低于糖尿病组和正常对照组的(24.07±4.11)%和(28.76±7.14)%,差异有统计学意义(P<0.05);3组Treg细胞比例比较,差异无统计学意义(P>0.05)。结论外周血Treg细胞可能参与了增殖性糖尿病视网膜病的发病机制,有待临床进一步研究。Objective To investigate the expression of CD4＋CD25＋T cells in patients with proliferative diabetic retinopathy （PDR）. Methods F＇rom June 2014 to May 2015, 42 cases of patients with vitreous hemorrhage diabetic retinopathy （PDR group） and 30 patients of type 2 diabetes without PDR （diabetic group） were selected in Xi＇an NO.4 Hospital, at the same time, 30 healthy volunteers （control group） were also included. Peripheral blood CD4＋CD25＋ T cell was detected in every group by flow cytometry, and the glycosylated hemoglobin（HbA1c）, triglyceride （TG）, total cholesterol （TC）, low-density lipoprotein （LDL-C）, low-density lipoprotein （HDL-C）, urea nitrogen （BUN） were tested. Results Age, gender differences in PDR group, diabete group and control group had no statistical significance （P 〉 0.05）; the levels of HbA1c, TG, BUN in PDR group were （8.02±2.53）%,（2.01±1.04） mmol/L and （7.88±1.43） mmol/L, significantly higher than the normal group （P 〈 0.05）; the levels of TC, LDL-C and Ser in PDR group were （5.44±1.21） mmol/L, （3.78± 1.06） mmol/L and （118.63±34.16） μmol/L, significantly higher than the diabetic group and control group （P 〈 0.05）,but HDL-C （1.22 ±0.34 mmol/L） was lower than the control group （P 〈 0.05）; peripheral blood CD4＋ T eell in PDR group was （18.21±5.34）%, significantly lower than that of diabetes group and control group [（24.07±4.11）% and （28.76± 7.14）%], the differences were statistically significant （P 〈 0.05）. The differences of CD4＋CD25＋T cells among the three groups were not statistically significant （P 〉 0.05）. Conclusion The peripheral blood CD4＋CD25＋ T cells may be involved in the pathogenesis of proliferative diabetic retinopathy, pending further clinical research.

关 键 词：增殖性糖尿病视网膜病 流式细胞仪 CD4+CD25+T细胞 临床研究 

分 类 号：R774.1[医药卫生—眼科]