·糖尿病慢性肾脏疾病·

　　【摘要】 目的 探讨T2DM患者尿白蛋白排泄率(UAER)与外周血淋巴细胞活化的关系。 方法 纳入100例T2DM患者，根据UAER水平，分为不伴白蛋白尿(A)组和伴有白蛋白尿(B)组，并设健康对照(C)组，分析UAER与淋巴细胞活化水平和其他指标的相关性。 结果 T淋巴细胞HLA-DR抗原阳性(CD3+ HLA-DR+)细胞比率A组高于C组[9.7 (6.1～13.9)% vs 6.2 (4.0～10.2)%, P<0.05]。B淋巴细胞HLA-DR抗原阳性(CD3–HLA-DR+)细胞比率B组低于A组[(15.7±5.7)% vs (18.3±5.2)%, P<0.05]。Spearman相关分析显示，UAER与年龄、病程、SBP及SUA呈正相关，而与CD3–HLA-DR+细胞比率和估算肾小球滤过率(eGFR)呈负相关。 结论 免疫学异常可能在T2DM患者CKD的病理生理机制发挥一定的作用。

　　【关键词】 淋巴细胞活化;糖尿病，2型;尿白蛋白排泄率

Relationship between urinary albumin excretion rate and peripheral blood lymphocyte activation in patients with type 2 diabetes CHEN Xiao-min, HUANG Qun, SHEN Xing-ping, et al. Department of Endocrinology, Xiamen University Zhongshan Hospital, Xiamen 361004, China

　　【Abstract】 Objective To evaluate the relationship between urinary albumin excretion rate (UAER) and peripheral blood lymphocyte activation in patients with T2DM. Methods According to the levels of UAER, 100 T2DM patients were classified into two groups, without albuminuriaor(A group) and with albuminuria(B group). Another 38 healthy subjects served as normal control(C group). The activation of lymphocytes as shown by the percentages of of CD3+HLA-DR+ and CD3–HLA-DR+ was measured using flow cytometry. The lymphocyte activation indexes in peripheral blood were compared among three groups and the association of these indexes with UAER was analyzed. Results The percentages of CD3+HLA-DR+ T lymphocytes in A group were higher than in C group [9.7(6.1～13.9)% vs 6.2(4.0～10.2)%, P<0.05]. The percentages of CD3+HLA-DR+ in B group to have a lower trend as compared A group although there was no significant difference. Moreover, the percentages of CD3–HLA-DR+ B lymphocytes in B group were lower than in A group [(15.7±5.7)% vs (18.3±5.2)%, P<0.05], and were no remarkably different with those in C group. Spearman analysis showed that the UAER was positively correlated with age, duration of diabetes, systolic blood pressure and serum uric acid, and negatively correlated with the percentages of CD3–HLA-DR+ and the levels of estimated glomerular filtration rate (eGFR). Conclusion Immune dysfunction may play a role in the pathogenesis of diabetic nephropathy in patients with T2DM.

　　【Key words】 Lymphocyte activation; Diabetes mellitus， type 2; Urinary albumin excretion rate