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目的:观察自然杀伤细胞(NK细胞)对妊娠期糖尿病患者并发高脂血症的影响。方法:选择2013年2月至2015年4月在我院确诊的妊娠期糖尿病高脂血症患者95例,作为研究组,同期选择体检健康孕妇100例,作为对照组,对比两组的血糖、糖化血红蛋白、身体质量指数(BMI)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、白细胞介素-2(IL-2)、IL-6、干扰素-γ(IFN-γ)、NK细胞及细胞亚型,并采用Person相关性分析NK细胞与血脂的相关性。结果:1研究组空腹血糖、餐后2 h血糖、糖化血红蛋白、BMI均明显高于对照组,差异具有统计学意义(P<0.05);2研究组TC、TG、LDL-C均明显高于对照组,HDL-C明显低于对照组,差异具有统计学意义(P<0.05);3研究组IL-2、IFN-γ明显低于对照组,差异具有统计学意义(P<0.05);IL-6明显高于对照组,差异具有统计学意义(P<0.05);4研究组的NK细胞数量、CD4+/CD3+、CD4+/CD8+、CD56++CD4+/CD3+均低于对照组的(P<0.05);CD8+/CD3+、CD18+/CD8+、CD19+/CD3+均高于对照组的(P<0.05);两组CD28+/CD8+差异无统计学意义(P>0.05)。5NK细胞数量与TC、TG、LDL-C水平均呈负相关(r=-0.527、-0.598、-0.485),NK细胞数量与HDL-C水平呈正相关(r=0.528)。结论:NK细胞在妊娠期糖尿病孕妇中数量减少,活性也降低,可能与参与免疫反应的NK细胞不同表型细胞含量发生变化,导致血脂调节失衡,引发高血脂症的过程有关。
Objective: To observe the effects of natural killer cells (NK cells) on hyperlipidemia in patients with gestational diabetes mellitus. Methods: 95 patients with gestational diabetes mellitus diagnosed in our hospital from February 2013 to April 2015 were selected as research group. 100 healthy pregnant women were selected as the control group in the same period. The blood glucose, HbA1c, BMI, TC, TG, LDL-C, HDL-C, (IL-2), IL-6, IFN-γ, NK cells and cell subtypes. The correlation between NK cells and blood lipids was analyzed by Person’s correlation. The levels of fasting blood glucose, postprandial blood glucose, glycosylated hemoglobin and BMI in study group were significantly higher than those in control group (P <0.05); 2 The levels of TC, TG and LDL-C in study group were significantly higher than those in control group The levels of HDL-C in the control group were significantly lower than those in the control group (P <0.05). The levels of IL-2 and IFN-γ in the study group were significantly lower than those in the control group (P <0.05). (P <0.05). The number of NK cells, the number of CD4 + / CD3 +, CD4 + / CD8 +, CD56 + + CD4 + / CD3 + of the study group were all lower than those of the control group (P <0.05). CD8 + / CD3 +, CD18 + / CD8 +, CD19 + / CD3 + were higher than those in the control group (P <0.05). There was no significant difference between the two groups (P> 0.05). The number of 5NK cells was negatively correlated with the level of TC, TG and LDL-C (r = -0.527, -0.598, -0.485). The number of NK cells was positively correlated with the level of HDL-C (r = 0.528). Conclusion: The number and activity of NK cells in pregnant women with gestational diabetes mellitus are decreased, which may be related to the changes of different phenotype cells of NK cells involved in immune response, leading to the imbalance of blood lipid regulation and the process of causing hyperlipidemia.