HIV／AIDS患者CD4＋T淋巴细胞数的变化与外周血淋巴细胞总数的变量的关系研究  

Study on the correlation between the change of CD4 ＋ T cell counts and the variance of total lymphocyte counts in HIV/AIDS patients

作　　者：孙希平[1] 夏德全[1] 赵利[1] 

机构地区：[1]山东省潍坊市益都中心医院感染科,262500

出　　处：《中国临床实用医学》2009年第6期21-23,共3页China Clinical Practical Medicine

摘　　要：目的研究人免疫缺陷病毒（HIV）感染者和艾滋病（AIDS）患者CIM＋T淋巴细胞数的变化（△CD4＋T）和外周血淋巴细胞总数的变量（△TLC）的相关性，探讨用△TLC预测CD4＋T在监测HIV疾病进展和高效抗逆转录病毒治疗（HAART）疗效中发挥的作用。方法分析91例HIV／AIDS患者CD4＋T和TLC及△CD4＋T和△TLC的相关性，通过ROC面积、敏感度、特异度、阳性预测值和阴性预测值分析，寻找能有效预测CD4＋T淋巴细胞数〈200个／μl，〈350个／μl，时TLC的范围；△CD4＋T淋巴细胞数为50个／μl、100个／μl、200个／μl、300个／μl时△TLC的范围。结果91例HIV／AIDS患者CD4＋T和TLC相关系数r为0．716，P〈0．01；△TLC和△CD4＋T具有更强的相关性，相关系数r为0．809，P〈0．01。用1300个／μl和1700个／μl TLC预测CD4＋T200个／μl和350个／μl具有显著的预测价值。用△TLC 170个／μl、330个／μl、630个／μl、910个／μl分别预测△CD4＋T50个／μl、100个／μl、200个／μl、300个／μl，各项预测指标基本上在90％以上，显著高于相同时间下TLC预测CD4＋T的效果。结论人免疫缺陷病毒（HIV）感染者和艾滋病（AIDS）患者CD4＋T淋巴细胞数的变化（△CD4＋T）和外周血淋巴细胞总数的变量（△TLC）具有直线相关性。在条件匮乏的艾滋病高发区，可以应用△TLC预测△CD4＋T．比TLC更加直观、准确的反映HIV感染者疾病进展和评价AIDS患者HAART的疗效。Objective To analyze the correlation between the change of CIM ＋ T lymphocyte count （△CD4 ＋T） and the variance of peripheral blood total lymphocyte count（ATLC） and evaluate the effect of ATLC to substitute for CD4 ＋ T count to predict HIV progression monitoring and the curative effect on clinical HAART treatment in HIV/AIDS patients. Methods Study the correlation between TLC and CD4 ＋ T count and the correlation between △TLC and △CD4 ＋ T count in 91 patients with HIV/AIDS. Study the date of ROC are- . a, sensitivity, specificity, positive predictive value and negative predictive value for CD4 ＋ T 200/μl, 350/μl to find the extent of TLC. Study the date of ROC area, sensitivity, specificity, positive predictive value and negative predictive value for △CD4 ＋ T 50/μl,100/μl,200/μl,300/μl to find the extent of ATLC. Results The sig- nificant correlation （r value） between TLC and CD4 ＋ T count was 0. 716 （P 〈 0.01 ） in the patients. The re- markable dynamical correlations between△TLC and △CD4 ＋ T were found comparing to that between TLC and CIM ＋ T count r value was 0. 809（P 〈0. 01 ）. It was significant value in prediction CIM ＋ T count 200/μl and 350/μl with TLC cut-off 1300/μl and 1700/μl. Moreover, as more significant market to predict optimal △CD4 ＋ T for 50μ1,100/μl, 200/μl, for300/μl, △TLC were 170/μl, 330/μl, 630/μl, 910/μl respectively. Conclu- sion There is straight line correlation between the change of CD4 ＋ T cell counts and the variance of total lym- phocyte counts in HIV/AIDS patients. TLC especially △TLC for prediction of △CD4 ＋ T can be available as a substitute method to estimate HIV disease progression and clinical HAART in some resource-constrained area of China.

关 键 词：HIV AIDS CD4+T淋巴细胞计数 外周血淋巴细胞-总数 变量 相关性 

分 类 号：R512.91[医药卫生—内科学] R622.4[医药卫生—临床医学]