PDR 患者外周血 CD4+CD25+T 细胞和相关基因 FOXP3的变化及临床意义

摘要

· AlM:To investigate changes and significance of CD4+CD25+T cells and expression of FOXP3 mRNA in peripheral blood mononuclear cell ( PBMC ) from patients with proliferative diabetic retinopathy ( PDR ) and observe its clinical significance on pathogenesis of PDR. n · METHODS: Flow cytometry was used to analyze the proportion of CD4+CD25+T cells in PBMC with PDR and normal control, the expression of FOXP3, lL-17, CTLA-4 mRNA in patients with PDR, diabetes and normal control were detected by Q-PCR.The clinical data of glycosylated hemoglobin ( HbA1c), age, blood lipid, renal function and the degree of their relevance were analysed by Wilcoxon rank and inspection, Linear correlation analysis. ·RESULTS:CD4+T cells decreased, CD4+CD25+T with no significant difference, FOXP3 and CLAT-4 decreased in PDR, lL -17 increased in PDR patients. CD4+T cells associated with age, the level of CD4+CD25+T was positive correlation with the patient’s serum creatinine ( Cr ) , but had no significant with age, HbA1c, blood lipid, Cr and urea nitrogen ( BUN ). HbA1c, triglyceride ( TG ), cholesterol, low density lipoprotein ( LDL ) were higher than normal value in PDR patients. n · CONCLUSlON: CD4+CD25+T cells may be involved in the pathogenesis of PDR.ln addition, abnormal blood lipid indicate that PDR may be associate with blood lipid level.%目的：探讨增殖性糖尿病视网膜病（ proliferative diabetic retinopathy，PDR）患者外周血CD4＋CD25＋T细胞及相关基因FOXP3表达变化意义，观察其在PDR发病中的临床意义。n　　方法：采用流式细胞术检测PDR患者及正常对照外周血CD4＋CD25＋T细胞比例，Q－PCR测PDR患者、糖尿病和正常人中 FOXP3， IL－17和CTLA－4的 mRNA 表达，并用Wilcoxon秩和检验和直线相关分析法分析PDR患者糖化血红蛋白、年龄、血脂、肾功能的临床资料及它们之间相关度。n　　结果：PDR患者CD4＋T细胞降低，CD4＋CD25＋T无显著差异，FOXP3和CTLA－4在PDR中下降， IL－17增高。 CD4＋T细胞与年龄相关，CD4＋CD25＋T与患者的血肌酐存在正相关性，CD4＋CD25＋T细胞水平与年龄、糖化血红蛋白、血脂、血肌酐（ Cr）、尿素氮（ BUN）均无明显相关性。 PDR患者糖化血红蛋白、甘油三酯、总胆固醇、低密度脂蛋白均高于正常值。n　　结论：CD4＋CD25＋T细胞可能参与PDR的发病机制，并且血脂异常提示PDR可能与血脂相关。