Immunity indicators in tuberculosis patients with diabetes mellitus and autoimmune thyroiditis

С.Л. Матвєєва, О. С. Шевченко
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Abstract

Objective — to study the parameters of immunity in tuberculosis with diabetes mellitus and with subclinical hypothyroidism against the background of autoimmune thyroiditis. Materials and methods. 60 patients with pulmonary tuberculosis and diabetes mellitus were under observation. In 30 patients with destructive tuberculosis and diabetes mellitus against the background of autoimmune thyroiditis with subclinical hypothyroidism, the parameters of humoral and cellular immunity were studied. The control group consisted of 30 patients with destructive tuberculosis and diabetes mellitus with intact structure and function of the thyroid gland. In patients of both groups, we assessed the state of T- and B-systems of immunity, natural killers. Results and discussion. The phenotyping of lymphocytes was carried out and the relative content of T-cells was determined: CD3+, T-helpers (CD4+), cytotoxic T-cells, B-lymphocytes (CD19+) and natural killer cells (CD16+). Using the enzyme immunoassay, the cytokine profile was determined: the levels of tumor necrosis factor-α, interferon-γ, interleukin-2, -6 and -4. It has been established that in patients with diabetes mellitus, both cellular and humoral immunity are suppressed. But a significantly more significant suppression of immunity was diagnosed in patients with tuberculosis against the background of diabetes mellitus and autoimmune thyroiditis with subclinical hypothyroidism. Conclusions. According to the authors, it is the deficiency of thyroid hormones that is the negative effect of a more significant suppression of immunity in patients autoimmune thyroiditis with subclinical hypothyroidism.
肺结核合并糖尿病、自身免疫性甲状腺炎患者的免疫指标分析
目的:探讨自身免疫性甲状腺炎背景下肺结核合并糖尿病和亚临床甲状腺功能减退患者的免疫指标。材料和方法。对60例肺结核合并糖尿病患者进行观察。本文对30例以自身免疫性甲状腺炎合并亚临床甲状腺功能减退为背景的破坏性肺结核合并糖尿病患者的体液免疫和细胞免疫指标进行了研究。对照组为甲状腺结构功能完整的破坏性肺结核合并糖尿病患者30例。在两组患者中,我们评估了T和b免疫系统的状态,即自然杀手。结果和讨论。对淋巴细胞进行表型分型,测定t细胞的相对含量:CD3+、t辅助细胞(CD4+)、细胞毒性t细胞、b淋巴细胞(CD19+)和自然杀伤细胞(CD16+)。采用酶免疫法测定细胞因子谱:肿瘤坏死因子-α、干扰素-γ、白细胞介素-2、-6和-4的水平。已经证实,在糖尿病患者中,细胞免疫和体液免疫都受到抑制。但在糖尿病和自身免疫性甲状腺炎合并亚临床甲状腺功能减退的背景下,肺结核患者的免疫抑制更为明显。结论。作者认为,在自身免疫性甲状腺炎合并亚临床甲状腺功能减退的患者中,甲状腺激素的缺乏是更显著的免疫抑制的负面影响。
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