摘要
目的研究2型糖尿病伴慢性牙周炎患者Th细胞及其细胞因子水平的变化,探讨糖尿病影响牙周炎的可能机制。方法收集2型糖尿病伴慢性牙周炎患者37例(T2DM+CP组)、慢性牙周炎患者31例(CP组)和正常对照组30例(NC组),通过流式细胞术检测T2DM+CP组、CP组和NC组外周血Th1、Th2和Th17细胞的分布差异,并进一步分析3组人群中血清和龈沟液标本中Th细胞亚群相关细胞因子白细胞介素(IL)-2、IL-4、IL-10、IL-17、肿瘤坏死因子-β(TNF-β)、γ干扰素(IFN-γ)水平的差异。结果 T2DM+CP组外周血中Th1、Th2、Th17细胞所占比例为(4. 32±0. 62)%、(0. 30±0. 22)%、(1. 73±0. 49)%; CP组3种细胞所占比例为(3. 49±0. 25)%、(0. 35±0. 29)%、(0. 72±0. 13)%; NC组为(2. 87±0. 76)%、(0. 54±0. 14)%、(0. 47±0. 23)%。与NC组相比,T2DM+CP组Th1、Th17比例显著增高(P <0. 05),Th2比例显著降低(P <0. 05);与CP组比较,T2DM+CP组Th1和Th17细胞所占比例显著增高(P <0. 05),Th2比例改变无显著差异(P> 0. 05)。T2DM+CP组血浆中的IL-17、IFN-γ浓度高于CP组和NC组(P <0. 05);其龈沟液中的IL-17浓度高于CP组和NC组(P <0. 05)。其他细胞因子浓度在T2DM+CP组存在升高的趋势,但差异无统计学意义(P> 0. 05)。结论 2型糖尿病合并牙周炎后加重了Th1、Th2失衡程度,血浆和龈沟液中IL-17升高,加重了Th17诱导的炎症反应,提示此可能是牙周炎发生的重要促炎症细胞因子。糖尿病可能通过Th1/Th2/Th17细胞亚群共同发挥致病作用。
引文
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