血糖波动与糖尿病足患者免疫功能改变的相关性研究  

Study on the Correlation Between Blood Sugar Fluctuation and the Change of Immune Function in Patients with Diabetic Foot

作　　者：潘幸 蔡丽娟 谢勇丽[1] 张雅薇[1] PAN Xing;CAI Li-juan;XIE Yong-li;ZHANG Ya-wei(Department of Endocrinology,Jiangxi Pingxiang People's Hospital,Pingxiang 337000,Jiangxi,China)

机构地区：[1]江西省萍乡市人民医院内分泌科,江西萍乡337000

出　　处：《医学信息》2021年第13期84-87,共4页Journal of Medical Information

基　　金：江西省卫生健康委科技计划项目(编号:20202059)。

摘　　要：目的探讨血糖波动与糖尿病足(DF)患者免疫功能改变的相关性。方法收集2019年1月-2020年12月在我院接受治疗的90例糖尿病足患者,根据DF病情严重性程度,分为轻度DF组、中度DF组和重度DF组,各30例,另选同期30例健康志愿者作为NC组和30例单纯糖尿病患者作为SDM组,比较五组糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2h PG)、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+))、IgG、IgM、IgA、补体C3、补体C4和血糖波动指标[日内最大波动幅度(LAGE)、全天血糖标准差(SDBG)、餐后血糖波动幅度(PPGE)、空腹血糖的变异系数(CV-FPG)]的差异。结果中、重度DF组HbA1c、FPG均高于轻度DF组、SDM组和NC组,DF组2hPG均高于NC组、SDM组,差异均有统计学意义(P<0.05);中、重度DF组CD4^(+)、CD4^(+)/CD8^(+)值、IgM水平低于SDM组和NC组,差异有统计学意义(P<0.05);中、重度DF组LAGE、SDBG、PPGE、CV-FPG均高于SDM组和NC组,差异有统计学意义(P<0.05);DF患者SDBG与CD4/CD8、IgM呈负相关(r=-0.554、-0.427)。结论 2型糖尿病患者的免疫功能存在紊乱,且与患者血糖控制情况密切相关,糖尿病足患者因血糖波动导致机体免疫力降低而易发生感染;积极治疗糖尿病,使血糖正常化,可在一定程度上防治糖尿病足。中、重度糖尿病足患者血糖变异性较大,可能是导致糖尿病足发生发展的重要原因。Objective To explore the correlation between blood glucose fluctuation and the changes of immune function in patients with diabetic foot(DF).Methods Collected 90 diabetic foot patients who were treated in our hospital from January 2019 to December 2020.According to the severity of DF,it was divided into mild DF group,moderate DF group and severe DF group,with 30 cases in each group.In the same period,30 healthy volunteers were selected as the NC group and 30 patients with simple diabetes were selected as the SDM group.Compare five groups of glycosylated hemoglobin(HbA1c),fasting blood glucose(FPG),2 h postprandial blood glucose(2hPG),T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+)),IgG,IgM,IgA,complement C3,complement C4 and blood glucose the difference in fluctuation indicators[the maximum intraday fluctuation range(LAGE),the standard deviation of the whole day blood glucose(SDBG),the postprandial blood glucose fluctuation range(PPGE),the coefficient of variation of fasting blood glucose(CV-FPG)].Results HbA1c and FPG in the moderate and severe DF groups were higher than those in the mild DF group,SDM group and NC group.2hPG in the DF group was higher than that in the NC group and SDM group,the differences were statistically significant(P<0.05);The CD4^(+),CD4^(+)/CD8^(+)values and IgM levels of the moderate and severe DF groups were lower than the SDM group and NC group,the difference was statistically significant(P<0.05);LAGE,SDBG,PPGE,CV-FPG in the moderate and severe DF group were higher than those in the SDM group and NC group,the difference was statistically significant(P<0.05);SDBG in DF patients was negatively correlated with CD4/CD8 and IgM(r=-0.554,-0.427).Conclusion The immune function of type 2 diabetic patients is disordered,and it is closely related to the patient's blood sugar control.Diabetic foot patients are prone to infection due to decreased immunity of the body due to blood glucose fluctuations;Active treatment of diabetes to normalize blood sugar can prevent and treat diabetic foot to a certai

关 键 词：糖尿病足 血糖波动 细胞免疫 体液免疫 

分 类 号：R587.1[医药卫生—内分泌]