柯萨奇B组病毒感染对1型糖尿病患儿胰岛功能的影响  

Effect of Coxsackie Virus B Infection on Pancreatic Islet Function in Children with Type I Diabetes

作　　者：谭琼 张鸿 杨菊 陈华明 赵明东 刘娟 丁小燕 TAN Qiong;ZHANG Hong;YANG Ju;CHEN Hua-ming;ZHAO Ming-dong;LIU Juan;DING Xiao-yan(Department of Pediatrics,Nanchong Central Hospital,Nanchong,Sichuan 637000,China;Clinical Laboratory,Nanchong Central Hospital,Nanchong,Sichuan 637000,China)

机构地区：[1]南充市中心医院儿科,四川南充637000 [2]南充市中心医院检验科,四川南充637000

出　　处：《临床误诊误治》2020年第2期81-84,共4页Clinical Misdiagnosis & Mistherapy

基　　金：四川省卫计委科研课题(17PJ0725)

摘　　要：目的探讨柯萨奇B组病毒(coxsackie virus B, CVB)感染对1型糖尿病患儿胰岛功能的影响。方法选取2014年2月-2018年5月南充市中心医院收治的85例1型糖尿病患儿作为观察组,另选取同期在该院进行体检健康的30例患儿作为对照组,比较两组CVB-IgM、胰岛功能相关指标[空腹血糖(fasting plasma glucose, FPG)、C肽、胰岛素]及T淋巴细胞亚群(CD4+、CD8+、CD4+/CD8+)水平,分析CVB-IgM阳性及CVB-IgM阴性1型糖尿病患儿胰岛功能相关指标和T淋巴细胞亚群水平。结果与对照组比较,观察组CVB-IgM阳性率、FPG水平及CD8+T淋巴细胞比例显著升高,胰岛素、C肽水平及CD4+T淋巴细胞比例、CD4+/CD8+值显著降低,差异具有统计学意义(P<0.01)。与CVB-IgM阴性1型糖尿病患儿比较,CVB-IgM阳性1型糖尿病患儿FPG水平、CD8+T淋巴细胞比例升高,胰岛素、C肽水平及CD4+T淋巴细胞比例、CD4+/CD8+值降低,差异具有统计学意义(P<0.05或P<0.01)。结论 CVB感染可导致1型糖尿病患儿机体免疫功能失衡,胰岛功能降低,临床应注意防治。Objective To investigate the effect of Coxsackie virus B(CVB) infection on pancreatic islet function in children with Type I diabetes. Methods Eighty-five children with Type I diabetes mellitus(TIDM) who were admitted to Nanchong Central Hospital between February 2014 and May 2018 were included in the observation group. Another 30 healthy children who underwent physical examination during the same period were selected as the control group. The CVB IgM, changes in levels of pancreatic islet function related indexes [fasting plasma glucose(FPG), C peptide, and insulin] and T lymphocyte subsets(CD4+, CD8+, and CD4+/CD8+) were compared between the two groups. The changes in levels of pancreatic islet function related indexes and T lymphocyte subsets in children with CVB IgM negative and positive TIDM were analyzed. Results The positive rate of CVB IgM, FPG level and ratio of T lymphocytes CD8+ in the observation group were significantly higher than those in the control group, while levels of insulin and C peptide, ratio of lymphocytes CD4+ and CD4+/CD8+ ratio were significantly lower than those in the control group(P<0.01). The FPG level and ratio of T lymphocytes CD8+ in CVB IgM positive TIDM patients were significantly higher than those in CVB IgM negative TIDM patients, while levels of insulin and C peptide, ratio of lymphocytes CD4+ and CD4+/CD8+ ratio were significantly lower than those in CVB IgM negative TIDM patients(P<0.05 or P<0.01). Conclusion CVB infection can lead to immune imbalance and decrease the pancreatic islet function in children with TIDM, which, therefore, needs to be prevented and treated in clinical settings.

关 键 词：糖尿病 1型 儿童 柯萨奇病毒感染 胰岛素 T淋巴细胞 

分 类 号：R587.1[医药卫生—内分泌]