本文選題：糖尿病　切入點(diǎn)：弓形蟲感染　出處：《貴州醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:調(diào)查糖尿病患者的弓形蟲感染情況,探討糖尿病合并弓形蟲感染患者的免疫功能狀態(tài)及其對(duì)血糖和肝腎功能的影響。方法:1.405例糖尿病患者(DM組)和150例正常對(duì)照人群(NC組)均選自貴州醫(yī)科大學(xué)附屬醫(yī)院。根據(jù)弓形蟲抗原抗體的檢測(cè)結(jié)果將DM組又分為DM合并弓形蟲感染陽(yáng)性組(DM-TP組)和DM合并弓形蟲感染陰性組(DM-TN組)。2.采集所有研究對(duì)象的外周血樣本。應(yīng)用酶聯(lián)免疫吸附試驗(yàn)(ELISA)檢測(cè)其血漿中弓形蟲特異性抗體(IgG、IgM)及循環(huán)抗原(CAg);用聚合酶鏈反應(yīng)(PCR)擴(kuò)增弓形蟲的529bp基因片段以檢測(cè)弓形蟲核酸;用ELISA定量檢測(cè)血漿細(xì)胞因子IFN-γ、IL-2和IL-4的含量;收集入組病例的25(OH)D3、空腹血糖(FBG)、糖化血紅蛋白(HbA1c)、肝功能指標(biāo)[總蛋白(TP)、白蛋白(ALB)、谷丙轉(zhuǎn)氨酶(ALT)、谷草轉(zhuǎn)氨酶(AST)]及腎功能指標(biāo)[血肌酐(Scr)、尿素氮(BUN)、尿酸(UA)及尿微量白蛋白/肌酐(UmALB/Ucr)]等臨床數(shù)據(jù)。3.用SPSS17.0軟件進(jìn)行數(shù)據(jù)分析:計(jì)數(shù)資料采用χ2檢驗(yàn),計(jì)量資料多組間比較采用單因素方差分析或秩和檢驗(yàn),相關(guān)性分析用Pearson相關(guān)分析,P0.05為差異具有統(tǒng)計(jì)學(xué)意義。結(jié)果:1.DM組和NC組弓形蟲感染血清學(xué)總陽(yáng)性率分別為19.75%、6.67%,兩組間比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。其中DM組弓形蟲Ig G類抗體、IgM類抗體及循環(huán)抗原(CAg)的陽(yáng)性率分別為17.28%、2.72%和0.49%,有3例弓形蟲IgG類抗體和IgM類抗體雙陽(yáng)性病人。NC組中未檢測(cè)到弓形蟲IgM類抗體和循環(huán)抗原(CAg)。2.本研究在所有研究對(duì)象中均未檢測(cè)到弓形蟲特異性核酸片段,因此未能進(jìn)行弓形蟲基因分型。3.DM-TP組及DM-TN組的25(OH)D3含量(16.75±4.69ng/ml、19.70±4.41 ng/ml)均明顯低于NC組(37.55±7.35ng/ml),DM-TP組又低于DM-TN組(P0.05)。4.DM-TP組的IFN-γ、IL-2(52.08±9.25pg/ml、174.48±68.69pg/ml)明顯高于DM-TN組(45.07±7.89pg/ml、137.37±27.26pg/ml)和NC組(40.20±7.61pg/ml、135.30±26.82pg/ml),而三組間IL-4水平比較無(wú)顯著性差異(P0.05)。5.DM-TP組、DM-TN組和NC組的FBG和HbA1c分別為(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%),組間兩兩比較均有統(tǒng)計(jì)學(xué)意義(P0.05);DM-TP組的TP、ALB均低于DM-TN組和NC組(P0.05),而其ALT水平則明顯高于DM-TN組和NC組(P0.01);DM-TP組的Scr和UmALB/Ucr均高于DM-TN組和NC組,兩兩比較均有統(tǒng)計(jì)學(xué)意義(P0.05),而三組的AST、BUN和UA比較均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。6.相關(guān)性分析:25(OH)D3與HbA1c、IFN-γ和IL-2均呈負(fù)相關(guān)關(guān)系(P0.05),而與FBG和IL-4無(wú)相關(guān)關(guān)系(P0.05)。結(jié)論:1.糖尿病患者弓形蟲感染率高于一般健康人群;2.糖尿病合并弓形蟲感染患者體內(nèi)維生素D水平和Th1/Th2平衡失調(diào)可能導(dǎo)致其免疫功能紊亂;3.弓形蟲感染可能對(duì)糖尿病患者血糖和肝腎功能有一定的影響;4.人外周血中弓形蟲核酸檢出陽(yáng)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- 緯 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 鹵4.69 ng / ml) were significantly lower than those of NC group (37.55 鹵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 鹵7.61pgml / ml 135.30 鹵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 鹵7.89pggml137.37 鹵27.26pggml-1) and the NC group (40.20 鹵7.61pgmlml-1 鹵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 鹵7.89pggml137.37 鹵27.26pggml-1) and the NC group (40.20 鹵7.61pgml-1 鹵26.82pgml / ml). The FBG and HbA1c of DM-TN group and NC group were 11.23 鹵2.27mmol / L 9.32 鹵1.98mmol / L 9.24 鹵2.74mmol / L 8.11 鹵1.27mol / L 8.11 鹵1.274mmol / L = 4.78 鹵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- 緯 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.
【學(xué)位授予單位】：貴州醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R587.1;R531.8;R446.6

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 田麗珠;朱曉菲;;維生素D水平與糖代謝異常的相關(guān)性研究[J];中國(guó)醫(yī)藥指南;2016年32期

2 范樂(lè)平;張s，

本文編號(hào)：1677434