·糖尿病临床研究·

　　【摘要】 目的 探讨新诊断T2DM与柯萨奇病毒(COX)、巨细胞病毒(CMV)、单纯疱疹病毒(HSV)及EB病毒(EBV)感染的关系，分析T2DM病毒感染患者血清IL-18、干扰素-γ(IFN-γ)及IFN-γ诱导蛋白-10(IP-10)的水平及意义。 方法 选取新诊断T2DM患者(T2DM组)208例和健康对照(NC)者240名，检测血清COX、CMV、HSV、EBV IgG抗体阳性率和炎症因子IL-18、IFN-γ及IP-10水平，比较两组病毒抗体阳性率与炎症因子水平的差异，分析T2DM病毒感染与炎症因子的关系。 结果 T2DM组COX、CMV抗体阳性率高于NC组(19.23% vs 0.83%，94.71% vs 83.33%，P<0.01)，两组HSV和EBV抗体均为阴性。T2DM组IL-18、IFN-γ及IP-10水平均高于NC组[IL-18：(130.30±118.44) vs (41.69±40.39) pg/ml;IFN-γ:(103.93±110.10) vs (34.50±24.89) pg/ml;IP-10：(2215.50±3395.47) vs (234.55±64.40) pg/ml，P<0.01]。T2DM COX感染者IL-18高于无COX感染者[(142.84±150.63) vs (122.04±92.59) pg/ml, P<0.05]。 结论 COX感染与新诊断T2DM的发生发展存在一定的相关性，可能与IL-18等的作用相关。

　　【关键词】 糖尿病，2型;柯萨奇病毒;巨细胞病毒;白介素-18;干扰素-γ;干扰素-γ诱导蛋白-10

　　【Abstract】 Objective To investigate the association between newly diagnosed T2DM and coxsackievirus(COX), cytomegalovirus(CMV), herpes simplex virus(HSV) and epstein-barr virus(EBV) infection, and explore the levels and significance of serum interleukin-18(IL-18), interferon -γ(IFN-γ) and IFN-γ-inducible protein-10(IP-10) in T2DM patients with viral infection. Methods 208 newly diagnosed T2DM patients and 240 healthy controls were enrolled. Serum anti-COX, anti-CMV, anti-HSV and anti-EBV IgG antibodies were detected, and serum inflammatory cytokines IL-18, IFN-γ and IP-10 levels were measured. Compared the positive rates of viral antibody and the levels of inflammatory cytokines between two groups, and analyzed the correlation between viral infection and inflammatory cytokines in type 2 diabetes. Results The positive rates of anti-COX and anti-CMV antibodies were significantly higher in T2DM group than in NC group(19.23% vs 0.83%，94.71% vs 83.33%，P<0.01), while HSV and EBV antibodies were negative in two groups. The levels of serum IL-18, IFN-γ and IP-10 were higher in T2DM group than in NC group[IL-18：(130.30±118.44) vs (41.69±40.39) pg/ml;IFN-γ:(103.93±110.10) vs (34.50±24.89) pg/ml;IP-10：(2215.50±3395.47) vs (234.55±64.40) pg/ml，P<0.01]. IL-18 level in T2DM with COX infection was higher than patients without COX infection[(142.84±150.63) vs (122.04±92.59) pg/ml, P<0.05]. Conclusion COX infection may play an important role in the pathogenesis of newly diagnosed T2DM, which may be associated with IL-18.

　　【Key words】 Diabetes mellitus, type 2; Coxsackievirus; Cytomegalovirus; Interleukin-18; Interferon-γ; IFN-γ-inducible protein-10