糖尿病合并弓形虫感染患者体内维生素D、细胞因子、血糖及肝肾功能的水平研究

发布时间：2018-03-28 18:03

本文选题：糖尿病　切入点：弓形虫感染　出处：《贵州医科大学》2017年硕士论文

【摘要】：目的:调查糖尿病患者的弓形虫感染情况,探讨糖尿病合并弓形虫感染患者的免疫功能状态及其对血糖和肝肾功能的影响。方法:1.405例糖尿病患者(DM组)和150例正常对照人群(NC组)均选自贵州医科大学附属医院。根据弓形虫抗原抗体的检测结果将DM组又分为DM合并弓形虫感染阳性组(DM-TP组)和DM合并弓形虫感染阴性组(DM-TN组)。2.采集所有研究对象的外周血样本。应用酶联免疫吸附试验(ELISA)检测其血浆中弓形虫特异性抗体(IgG、IgM)及循环抗原(CAg);用聚合酶链反应(PCR)扩增弓形虫的529bp基因片段以检测弓形虫核酸;用ELISA定量检测血浆细胞因子IFN-γ、IL-2和IL-4的含量;收集入组病例的25(OH)D3、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、肝功能指标[总蛋白(TP)、白蛋白(ALB)、谷丙转氨酶(ALT)、谷草转氨酶(AST)]及肾功能指标[血肌酐(Scr)、尿素氮(BUN)、尿酸(UA)及尿微量白蛋白/肌酐(UmALB/Ucr)]等临床数据。3.用SPSS17.0软件进行数据分析:计数资料采用χ2检验,计量资料多组间比较采用单因素方差分析或秩和检验,相关性分析用Pearson相关分析,P0.05为差异具有统计学意义。结果:1.DM组和NC组弓形虫感染血清学总阳性率分别为19.75%、6.67%,两组间比较差异有统计学意义(P0.05)。其中DM组弓形虫Ig G类抗体、IgM类抗体及循环抗原(CAg)的阳性率分别为17.28%、2.72%和0.49%,有3例弓形虫IgG类抗体和IgM类抗体双阳性病人。NC组中未检测到弓形虫IgM类抗体和循环抗原(CAg)。2.本研究在所有研究对象中均未检测到弓形虫特异性核酸片段,因此未能进行弓形虫基因分型。3.DM-TP组及DM-TN组的25(OH)D3含量(16.75±4.69ng/ml、19.70±4.41 ng/ml)均明显低于NC组(37.55±7.35ng/ml),DM-TP组又低于DM-TN组(P0.05)。4.DM-TP组的IFN-γ、IL-2(52.08±9.25pg/ml、174.48±68.69pg/ml)明显高于DM-TN组(45.07±7.89pg/ml、137.37±27.26pg/ml)和NC组(40.20±7.61pg/ml、135.30±26.82pg/ml),而三组间IL-4水平比较无显著性差异(P0.05)。5.DM-TP组、DM-TN组和NC组的FBG和HbA1c分别为(11.23±2.27mmol/L、9.32±1.98%)、(9.24±2.74mmol/L、8.11±1.27%)、(5.01±0.84mmol/L、4.78±0.59%),组间两两比较均有统计学意义(P0.05);DM-TP组的TP、ALB均低于DM-TN组和NC组(P0.05),而其ALT水平则明显高于DM-TN组和NC组(P0.01);DM-TP组的Scr和UmALB/Ucr均高于DM-TN组和NC组,两两比较均有统计学意义(P0.05),而三组的AST、BUN和UA比较均无统计学意义(P0.05)。6.相关性分析:25(OH)D3与HbA1c、IFN-γ和IL-2均呈负相关关系(P0.05),而与FBG和IL-4无相关关系(P0.05)。结论:1.糖尿病患者弓形虫感染率高于一般健康人群;2.糖尿病合并弓形虫感染患者体内维生素D水平和Th1/Th2平衡失调可能导致其免疫功能紊乱;3.弓形虫感染可能对糖尿病患者血糖和肝肾功能有一定的影响;4.人外周血中弓形虫核酸检出阳性率低。
[Abstract]:Objective: to investigate the infection of Toxoplasma gondii in diabetic patients. To investigate the immune function of diabetic patients with Toxoplasma gondii infection and its effect on blood glucose, liver and kidney function. Methods 1.405 diabetic patients with diabetes mellitus (DM group) and 150 normal control subjects (NC group) were selected from affiliated of Guizhou Medical University. Hospital. According to the test results of Toxoplasma gondii antigen and antibody, DM group was subdivided into DM + Toxoplasma infection positive group (DM-TP group) and DM complicated with Toxoplasma gondii infection negative group (DM-TN group). The 529bp gene fragment of Toxoplasma gondii was amplified by polymerase chain reaction (PCR) to detect the nucleic acid of Toxoplasma gondii. The levels of IL-2 and IL-4 in plasma cytokines IFN- 纬 were determined by ELISA. A total of 25 OHHN D3, FBGG, HbA1cU, liver function indexes (total protein TPN, Albumin, alanine aminotransferase (alt), alanine aminotransferase (AST)), renal function indexes [serum creatinine (SCR), urea bun (bun), uric acid (UAU)] and urine microalbuminated eggs were collected. White / creatinine UmALB / Ucr. et al. 3. Data analysis with SPSS17.0 software: count data were analyzed by 蠂 2 test. One-factor ANOVA or rank sum test were used to compare the measurement data among groups. Results 1. The total positive rates of Toxoplasma gondii infection in DM group and NC group were 19.757.67, respectively, and there was significant difference between the two groups (P 0.05), among which Toxoplasma gondii Ig G in DM group was significantly higher than that in DM group (P < 0.05), and the positive rate of Toxoplasma gondii infection in DM group was higher than that in NC group (P < 0.05). The positive rates of Toxoplasma IgG antibody and circulating antigen were 17.282.72% and 0.49%, respectively. There were 3 cases of Toxoplasma gondii IgG antibody and IgM antibody double positive patients. No Toxoplasma gondii IgM antibody and circulating antigen were detected in the NC group. No specific DNA fragments of Toxoplasma gondii were detected. Therefore, the 25(OH)D3 content of Toxoplasma gondii genotypes. 3.DM-TP group and DM-TN group (16.75 卤4.69 ng / ml) were significantly lower than those of NC group (37.55 卤7.35 ng / ml DM-TP group) and DM-TN group (P 0.05 .4.DM-TP group), but there was no significant difference in IL-4 level among the three groups (P0.020 卤7.61pgml / ml 135.30 卤26.82pgml / ml), but there was no significant difference among the three groups in the level of IL-4 in the DM-TN group (45.07 卤7.89pggml137.37 卤27.26pggml-1) and the NC group (40.20 卤7.61pgmlml-1 卤26.82pgml-1 / ml), but there was no significant difference among the three groups in the IL-4 level of the Toxoplasma gondii group. 3. 3. DM-TP group and the DM-TN group were significantly higher than those in the DM-TN group (45.07 卤7.89pggml137.37 卤27.26pggml-1) and the NC group (40.20 卤7.61pgml-1 卤26.82pgml / ml). The FBG and HbA1c of DM-TN group and NC group were 11.23 卤2.27mmol / L 9.32 卤1.98mmol / L 9.24 卤2.74mmol / L 8.11 卤1.27mol / L 8.11 卤1.274mmol / L = 4.78 卤0.590.The ALT levels in DM-TN group and NC group were significantly lower than those in DM-TN group and NC group, respectively. The ALT level in DM-TP group was significantly higher than that in DM-TN group and NC group. There was no significant difference in AST bun and UA between the two groups. The correlation analysis showed that there was a negative correlation between Toxoplasma gondii D3 and HbA1cn- 纬 and IL-2, but no correlation with FBG and IL-4. Conclusion Toxoplasma gondii is susceptible to Toxoplasma gondii in patients with diabetes mellitus (P < 0.05), and there is no significant correlation between it and Toxoplasma gondii (Toxoplasma gondii). Conclusion: Toxoplasma gondii is susceptible to Toxoplasma gondii in patients with diabetes mellitus (P < 0. 05). The infection rate of Toxoplasma gondii in diabetic patients with Toxoplasma gondii infection is higher than that in the normal population. The imbalance of vitamin D and Th1/Th2 may lead to the disorder of immune function. The infection of Toxoplasma gondii may have a significant effect on blood glucose and liver and kidney function in patients with diabetes mellitus. The positive rate of DNA detection of Toxoplasma gondii in human peripheral blood was low.
【学位授予单位】：贵州医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.1;R531.8;R446.6

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