2型糖尿病患者神经-内分泌-免疫网络有关指标的紊乱及其临床意义

 为分析2型糖尿病患者神经-内分泌-免疫网络紊乱情况及其临床意义，选择174例经临床诊断明确的2型糖尿病患者，用放射免疫法和流式细胞技术检测外周血中CD4+、CD8+、NK细胞数量、CD4+/CD8+比值及IL-1β、IL-6、TNF-α、ACTH、CORT、DA、NE水平，选择30例健康志愿者为正常对照组进行相同检测。结果显示，与正常对照相比，2型糖尿病患者CD4+、CD8+及NK细胞数量下降（P<0.01），CD8+及CD4+/CD8+比值升高（P<0.01），IL-1β、IL-6和TNF-α均有升高（P<0.01），ACTH及CORT下降（P<0.01），DA和NE升高（P<0.01）。研究表明，2型糖尿病患者神经-内分泌-免疫网络的紊乱中，其体液免疫增强、细胞免疫减弱，交感神经兴奋及应激性内分泌功能减弱为主要表现。对于2型糖尿病的治疗，除采用现有手段，应加强机体对胰岛素抵抗调控平衡态的修复与重建，重视神经-内分泌-免疫系统标志的检测及相应的新治疗研究。

Disorder of Neuro-Endocrine-Immune Network in Patients with Type-2 Diabetes Milletus and Its Clinical Significance

To investigate the disorder of neuro-endocrine-immune network in patients with type-2 diabetes milletus and its clinical significance, 174 patients with clinical proven type-2 diabetes mellitus were enrolled in the study. Radio-immune technology and flow cytometer technology were used to detect the blood levels of CD4+, CD8+, NK and CD4+/CD8+, and cytokines including IL-1β, IL-6, TNF-α, ACTH, CORT and DA as well as NE. Analyses were performed on the basis of gender with 33 normal people served as the control group. A significant decrease of CD4+, CD8+, NK lymphocytes count, and a significant increase of CD4+/CD8+ were found in type-2 diabetes milletus patients compared with the control group(P<0.01). Low IL-1β, IL-6 and TNF-α levels were found in type-2 diabetes milletus groups (P<0.01). The serum ACTH, CORT levels were decreased in type-2 diabetes milletus patients (P<0.01); both serum DA and NE levels were increased in type-2 diabetes milletus groups compared with the normal group(P<0.01). The disturbance of neuro-endocrine-immune network in patients with type-2 diabetes milletus is characterized by the humoral immunity activated and cellular immunity depressed； symphathetic nerve activated；the stress related endocrine depressed. It is important to strengthen and recover the balance of neuro-endocrine-immune network, for the treatment of type-2 diabetes mellitus, which is an important issue for the future research on diabetes.