重度烧伤患者血糖与炎性因子及免疫功能的相关性研究  

Correlation research of blood glucose with inflammatory factors and immune function in patients with severe burn

作　　者：马燕 郭莉娜[2] 李灿[2] 严伟恒 刘月明[1] 邓峰美[2] 刘卫华[1] 刘漪沦[1,2] Ma Yan;Guo Lina;Li Can;Yan Weiheng;Liu Yueming;Deng Fengmei;Liu Weihua;Liu Yilun(Department of Burns and Plastic Surgery,First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,China;School of Basic Medical Sciences,Chengdu Medical College,Chengdu 610500,China)

机构地区：[1]成都医学院第一附属医院烧伤整形外科,610500 [2]成都医学院基础医学院,610500

出　　处：《中华损伤与修复杂志（电子版）》2018年第4期273-277,共5页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

基　　金：四川省科技厅应用基础研究项目(2017JY0304;2017JY0150);四川省医学会科研课题计划(S16021);成都医学院科研创新团队项目(CYTD15-04);成都医学院第一附属医院专项科研基金(CYFY2017YB01)

摘　　要：目的研究重度烧伤患者血糖与炎性因子及免疫功能的相关性。方法选取2012年1月至2017年12月在成都医学院第一附属医院烧伤整形外科治疗的重度烧伤患者96例作为试验组,另选取成都医学院第一附属医院经体检证明健康的志愿者60名作为对照组,检测两组空腹血糖(FPG)、炎性因子及T淋巴细胞水平,比较两组间FPG、炎性因子以及T淋巴细胞水平之间的差异;再将试验组患者根据FPG浓度分为血糖正常组(17例,FPG<7.0 mmol/L)和血糖升高组(79例,FPG≥7.0 mmol/L),比较两组炎性因子以及T淋巴细胞水平之间的差异,并对重度烧伤患者的FPG与炎性因子及T淋巴细胞水平进行Pearson相关性分析。指标比较采用t检验。结果试验组患者FPG(11.39±2.28)mmol/L、C反应蛋白(CRP)(39.67±4.15)mg/L、肿瘤坏死因子-α(TNF-α)(108.12±6.49)ng/L、白细胞介素(IL)-6(139.77±7.43)ng/L、IL-8(91.56±4.91)ng/L,均高于对照组[FPG(5.07±1.15)mmol/L、CRP(5.91±0.76)mg/L、TNF-α(12.94±1.69)ng/L、IL-6(14.11±3.93)ng/L、IL-8(17.22±2.89)ng/L],差异均有统计学意义(t=5.365、4.365、11.912、9.834、6.139,P值均小于0.01);试验组患者免疫指标CD4+T淋巴细胞水平为(29.77±4.12)%、CD4+/CD8+为0.91±0.24,分别低于对照组(41.89±5.36)%、1.59±0.37,而试验组的CD8+T淋巴细胞水平为(32.69±4.73)%,高于对照组(25.83±3.52)%,差异均有统计学意义(t=3.931、2.433、2.696,P值均小于0.05)。试验组患者中,血糖升高组的血浆CRP(45.19±5.45)mg/L、TNF-α(121.81±5.43)ng/L、IL-6(153.31±5.57)ng/L、IL-8(106.56±5.65)ng/L、CD8+T淋巴细胞水平(35.46±4.11)%,均高于血糖正常组[CPR(36.67±3.45)mg/L、TNF-α(91.58±4.93)ng/L、IL-6(114.65±6.33)ng/L、IL-8(79.62±3.74)ng/L、CD8+T淋巴细胞水平(28.62±4.03)%],差异均有统计学意义(t=2.341、2.894、4.167、3.018、2.763,P值均小于0.05);CD4+T淋巴细胞水平(28.89±3.79)%、CD4+/CD8+(0.82±0.37)均低于血糖正常组[(33.47±4.98)%、(1.17±0.52)],差�Objective To investigate the correlation between blood glucose levels,inflammatory factors and immune function of patients who suffered from severe burns. Methods A sample size of 96 severe burns patients were chosen at Department of Burns and Plastic Surgery,First Affiliated Hospital of Chengdu Medical College over the period of January 2012 to December 2017,to serve as the experimental group; while 60 healthy volunteers after physical examination from First Affiliated Hospital of Chengdu Medical College served as control group. The fasting blood glucose（ FPG） level,inflammatory factors,and T-lmphocytes levels for both two groups were studied,and the differences between FPG,inflammatory factors,and T-lymphocytes levels were compared between the two groups. The patients in the experimental group were divided into normal blood glucose group（ FPG〈 7. 0 mmol/L） with 17 cases and high blood glucose group（ FPG≥7. 0 mmol/L） with 79 cases according to the FPG concentration. Data were compared with t test. Results The experimental group had FPG（11. 39 ± 2. 28） mmol/L,C-reactive protein（ CRP）was（39. 67 ± 4. 15） mg/L,tumor necrosis factor-α（ TNF） was（108. 12 ± 6. 49） ng/L,interleukin（ IL）-6 was（139. 77 ± 7. 43） ng/L,IL-8（ 91. 56 ± 4. 91） ng/L,higher than the control group [FPG（ 5. 07 ±1. 15） mmol/L,CRP was（5. 91 ± 0. 76） mg/L,TNF-α was（12. 94 ± 1. 69） ng/L,IL-6 was（14. 11 ±3. 93） ng/L,IL-8 was（ 17. 22 ± 2. 89） ng/L],the differences were statistically significant（ t = 5. 365,4. 365,11. 912,9. 834,6. 139; with P values below 0. 05）; in the experimental group,the immune index,CD4＋T-lymphocytes level was（29. 77 ± 4. 12） % and CD4＋/CD8＋was 0. 91 ± 0. 24,which were lower than those of the control group（41. 89 ± 5. 36） % and 1. 59 ± 0. 37. The CD8＋T-lymphocytes level in the experimental group was（ 32. 69 ± 4. 73） %,which was higher than the control group [（ 25. 83 ±3. 52） % ],the differences were statistically signifi

关 键 词：烧伤 血糖 肿瘤坏死因子Α 白细胞介素6 白细胞介素8 T淋巴细胞亚群 

分 类 号：R644[医药卫生—外科学]