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目的探讨自然杀伤细胞(NK)对妊娠期糖尿病高脂血症患者的影响。方法选择2012年1月至2013年12月确诊的妊娠期糖尿病高脂血症患者108例作为观察组,同期健康孕妇108例作为对照组。采用流式细胞术检测NK细胞,ELISA检测γ干扰素(IFN-γ),全自动生化检测仪检测血糖、血脂各项指标。分析和比较两组孕妇的NK细胞活性及血糖、血脂情况。结果与对照组比较,观察组的NK细胞数量、CD4+/CD3+、CD4+/CD8+和CD56++CD4+/CD3+水平均降低(P均<0.01);CD8+/CD3+、CD19+/CD3+、CD18+/CD8+水平均升高(P均<0.01);CD28+/CD8+水平与对照组无统计学差异(P>0.05)。与对照组比较,观察组孕妇IL-2水平降低(P<0.01),IL-6水平升高(P<0.01),IFN-γ水平降低(P<0.01)。观察组空腹血糖、餐后2 h血糖、糖化血红蛋白、体质指数以及甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)等水平均较对照组升高(P均<0.01),高密度脂蛋白胆固醇(HDL-C)水平较对照组降低(P<0.01)。NK细胞数量与TG(r=-0.603)、TC(r=-0.541)、LDL-C(r=-0.498)均呈负相关(P均<0.05),与HDL-C水平(r=0.537)呈正相关(P<0.05)。结论妊娠期糖尿病孕妇的NK细胞数量减少、活性降低,可能通过改变不同表型细胞的含量参与免疫反应,引发其调节血脂能力降低,影响妊娠糖尿病高脂血症的发生。
Objective To investigate the effect of natural killer cells (NK) on patients with gestational diabetes mellitus and hyperlipidemia. Methods One hundred and eight patients with gestational diabetes mellitus diagnosed from January 2012 to December 2013 were selected as observation group and 108 healthy pregnant women as control group. NK cells were detected by flow cytometry, IFN-γ was detected by ELISA, and blood glucose and blood lipid were detected by automatic biochemical analyzer. Analysis and comparison of NK cell activity and blood glucose, lipid status in two groups of pregnant women. Results Compared with the control group, the levels of NK cells, CD4 + / CD3 +, CD4 + / CD8 + and CD56 ++ CD4 + / CD3 + in the observation group were significantly lower than those in the control group (all P <0.01) (P <0.01). The level of CD28 + / CD8 + was not significantly different from that of the control group (P> 0.05). Compared with the control group, the levels of IL-2 in pregnant women in the observation group decreased (P <0.01), the levels of IL-6 increased (P <0.01) and the levels of IFN-γ decreased (P <0.01). Fasting blood glucose, postprandial blood glucose, glycosylated hemoglobin, body mass index, triglyceride (TG), total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) levels in observation group were higher than those in control group (All P <0.01). The level of HDL-C was lower than that of the control group (P <0.01). The number of NK cells was negatively correlated with TG (r = -0.603), TC (r = -0.541) and LDL-C (r = -0.498) (P <0.05). Conclusion The number of NK cells in pregnant women with gestational diabetes mellitus is decreased and the activity is decreased. It may be involved in the immune response by changing the content of different phenotype cells, leading to the decrease of their ability to regulate blood lipids and the occurrence of hyperlipidemia in gestational diabetes mellitus.