| Objective:Through the analysis of diabetes and early renal damage in patients with diabetic peripheral blood qing chemokines CXCR3 and its ligand MIG,IP-10 expression level,combined with peripheral blood lymphocyte total group,T lymphocyte count,Th17,Treg,the change of Th17 / Treg,explore the abnormal immune function under the environment of high blood sugar?CXCR3 and its ligand MIG,IP-10 whether to participate in the occurrence and development of diabetes early renal damage?clear CXCR3 and its ligand MIG,IP-10 in diabetes clinical significance of early renal damage?MethodsFrom November 1,2018 to November 31,2019,A total of 128 patients with T2 DM hospitalized in the department of endocrinology of the second clinical medical college of shanxi medical universitywere selected as the observation group?Among them,52 patients with early renal injury were selected as the case group,76 patients without renal injury as the control group,and 60 healthy patients during the same period were selected as the control group?Total T-lymphoid number,total number of Th lymphocytes,Th17 and Treg in peripheral blood were detected by bicolor flow cytometry,and Th17/Treg ratio was calculated?Serum CXCR3,MIG and IP-10 levels were detected by double antibody two-step sand wich enzyme-linked immunosorbent assay method?The measurement data were expressed x ±s,and the T test was used for normal distribution,while the row rank sum test was used for non-normal distribution?The enumeration data were expressed by rate(%),and the chi-squared test was used for comparison between groups?SPSS22.0 software was used for statistical analysis?Logistic linear regression analysis was performed for the correlation between factors such as Th17,Th17/Treg,CXCR3,MIG,IP-10 and urinary microalbumin/creatinine?Results1.2 the total number of T lymphocytes and the total number of Th lymphocytes in patients with type 2 diabetes mellitus(T2DM)discreased,and there was no statistical difference compared with the normal control group(P > 0.05)?The proportion of Th17 in peripheral blood increased,and there was a statistical difference compared with the normal control group(P<0.05)?The proportion of Treg in peripheral blood decreased,and there was no statistical difference compared with the normal control group(P>0.05).The peripheral blood Th17/Treg ratio was higher among the groups,showing a statistical difference(P<0.05)?Peripheral blood Th17 and Th17/Treg were positively correlated with urinary microalbumin/creatinine(ACR)in patients with type 2 diabetes and patients with combined kidney injury(r=1.316,P=0.004;r=88.336,P=0.004)?,2.2 the expression levels of CXCR3 and its ligand MIG and Ip-10 in peripheral blood of patients with type 2 diabetes were higher than those in the control group,showing statistical differences(P<0.05)?Compared with those without early kidney injury in diabetes mellitus,the expression levels of CXCR3 and MIG and IP-10 in the diabetic kidney injury group were higher,showing statistical differences(P<0.05)?Urinary microalbumin/creatinine(ACR)was significantly correlated with CXCR3,MIG and IP – 10 expression levels in peripheral blood(r=1.086,P=0.002;r=0.196,P= 0.001;r=1.311,P= 0.006)?ConclusionIn patients with type 2 diabetes,T lymphocyte subgroup expression is disordered,which is manifested by the increase of Th17 ratio in peripheral blood,the decrease of Treg ratio,and the increase of Th17/Treg ratio,which is more obvious with the increase of ACR?The expression levels of CXCR3,MIG and Ip-10 in patients with early kidney injury were significantly increased,which was positively correlated with ACR,suggesting that the expression levels of CXCR3,MIG and Ip-10 had a certain correlation with the occurrence of early kidney injury in diabetes mellitus,and could reflect the severity of kidney injury in type 2 diabetes mellitus to some extent?... |
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