【摘要】 目的探究睡眠改善对老年糖尿病合并失眠患者T淋巴细胞免疫功能的影响。方法收集2016年1月至2017年12月在广西壮族自治区人民医院内分泌代谢科干部病区住院的老年2型糖尿病患者79例作为单纯糖尿病组,另选择合并睡眠紊乱的同型糖尿病患者79例作为糖尿病合并睡眠紊乱组,随机选择同期来我院体检的79例健康人作为对照组。所有入组受试者均于清晨抽取静脉血测定空腹血糖、空腹胰岛素,并计算胰岛素抵抗指数(HOMA,空腹胰岛素×空腹血糖÷22.5);使用ELISA法测定血清中C反应蛋白、IL-2;收集受试者的全血,用抗体标记后使用流式细胞仪测定T淋巴细胞亚群CD4~+、CD8~+。合并睡眠紊乱组给药治疗8周后,所有受试者再次检测上述指标。结果对照组的空腹胰岛素显著高于干预后单纯糖尿病组与合并睡眠紊乱组,而空腹血糖显著低于后两者(P <0.05);合并睡眠紊乱组的空腹胰岛素、空腹血糖与胰岛素抵抗指数与单纯糖尿病组之间差异无统计学意义(P> 0.05);干预后,合并睡眠紊乱组的生化指标与CD4~+、CD8~+的水平显著优于干预前(P <0.05),且与单纯糖尿病组差异无统计学意义(P> 0.05);对照组与单纯糖尿病组的PSQI评分差异没有统计学意义(P>0.05),且均显著低于干预前合并睡眠紊乱组(P<0.05);三组受试者的PSQI评分干预后差异无统计学意义(P>0.05),且均低于睡眠障碍分界值(>7分)。结论睡眠质量的改善有助于糖尿病患者血糖和T淋巴细胞免疫功能的稳定。更多还原

【Abstract】 Objective To explore the effect of sleep improvement on T lymphocyte immune function in elderly patients with diabetes mellitus and insomnia.Methods Between January,2016 and December,2017 in Guangxi Zhuang autonomous region people’s hospital endocrine metabolism branch cadre ward,79 cases of elderly patients with type 2 diabetes were enrolled as the simple diabetes group,also 79 cases type 2 diabetes with sleep disorders as the sleep disorders diabetic group.Furthermore,we randomly selected 79 cases of healthy hospital physical examination as the control group.All the enrolled patients were drawn with the venous blood in the morning to measure fasting blood glucose and fasting insulin,and the insulin resistance quality was calculated(HOMA:fasting insulin fasting blood glucose 22.5);Serum c-reactive protein and IL-2 were determined by ELISA.The whole blood samples of the patients were collected and the T lymphocyte subsets CD4~+,CD8~+were determined by flow cytometry after labeling with antibodies.After 8 weeks of treatment,all patients in the sleep disorder group were tested again.Results After the intervention,fasting insulin in the control group was significantly higher than that in the simple diabetes group and the combined sleep disorder group,while fasting blood glucose was significantly lower(P <0.05).There were no significant differences for the fasting insulin,fasting blood glucose and insulin resistance quality between the combined sleep disorder group and the simple diabetes group(P>0.05).After the intervention,the ratio of the biochemical indexes to CD4~+and CD8~+in the sleep disorder group was significantly higher than that before the intervention(P <0.05),and there was no significant difference for that in the diabetes mellitus group(P>0.05).Before the intervention,there was no significant difference in PSQI score between the control group and the simple diabetes group(P>0.05),and both scores were significantly lower than those of the combined sleep disorder group(P <0.05).After the intervention,there was no significant difference in PSQI scores among the three groups(P>0.05),and all scores were lower than the sleep disorder threshold(> 7 points).Conclusion The improvement of sleep quality is helpful to stabilize blood glucose and T lymphocyte immune function in diabetic patients.更多还原