儿童HIV感染者及AIDS患者高效抗反转录病毒治疗前后T淋巴细胞及亚群的变化  

The changes and significance of T lymphocytes and subsets before and after receiving highly active anti-retroviral therapy in children infected with HIV or AIDS patients

作　　者：李剑军[1] 刘伟[1] 唐志荣[1] 梁富雄[1] 周崇兴[1] 梁淑家[1] 鲁鸿燕[1] 李国装[1] 王斌[1] 王江伟[1] 

机构地区：[1]广西壮族自治区疾病预防控制中心艾滋病性病防制科,南宁530028

出　　处：《中华预防医学杂志》2010年第11期989-992,共4页Chinese Journal of Preventive Medicine

摘　　要：目的观察儿童HIV感染者或AIDS患者接受高效抗反转录病毒治疗（HAART）前后T淋巴细胞及亚群的变化。方法选取2006年5月至2009年4月在广西壮族自治区疾病预防控制中心AIDS抗病毒治疗门诊接受HAART的儿童作为研究对象，共招募99例儿童HIV感染者或AIDS患者。分别在治疗前（D0），治疗后第3、6、12、18、24、30、36个月（M3、M6、M12、M18、M24、M30、M36）时随访调查并采集2ml静脉血，应用四色荧光标记流式细胞术检测外周血CD3^＋、CD4^＋、CD8^＋T淋巴细胞绝对数及CD3比率、CD4比率、CD8比率、CD4／CD8比值。结果99例研究对象的治疗方案为：拉米夫定（3TC）／齐多夫定（AZT）／奈韦拉平（NVP），65例（65．66％）；3TC／司他夫定（D4T）／NVP，16例（16．16％）；3TC／AZT／依非韦伦（EFV），8例（8．08％）；3TC／AZT／克力芝（LPV／r），10例（10．10％）。CD4／CD8比值的中位数在M3、M6、M12、M18、M24、M30、M36时分别为0．39、0．51、0．61、0．65、0．70、0．73、0．76，与DO时（0．19）比较，均有明显提高（Z值分别为-5．158、-7．375、-9．078、-8．853、-8．373、-5．845、-5．844，P值均〈0．000）。CD4比率的中位数在M3、M6、M12、M18、M24、M30、M36时分别为16．92％、22．70％、25．54％、26．66％、27．99％、30．36％、29．30％，与DO时（9．92％）比较，均有明显提高（Z值分别为-5．268、-7．568、-9．496、-9．171、-8．760、-6．190、-5．964，P值均〈0．000）。CD4^＋T淋巴细胞绝对数的中位数在M3、M6、M12、M18、M24、M30、M36时分别为631、813、1050、946、1057、1166、894个／mm^3，与DO时（382个／mm^3）比较，均有明显提高（Z值分别为-3．318、-5．288、-6．661、-5．886、-5．801、-4．110、-3．600，P值均〈0．000）。CD8比率的中位数在M3、M6、M12、M18、M24、M30、M36时分别为47．25％、43．01％、43．04％、42．60％、41�Objective To investigate the changes of the T lymphocytes and their subsets before and after receiving highly active anti-retroviral therapy （HAART） in children who were infected with HIV or AIDS patients. Methods Ninety-nine children met the criteria were recruited. All of them had received HAART in Guangxi Center for Disease Control and Prevention from May 2006 to April 2009. Peripheral blood of 2 milliliter was collected before treatment （D0） and after 3,6,12,18,24,30, and 36 months （ M3, M6, M I2,M18, M24, M30 and M36） , respectively. Four-color fluorescence flow cytometry was used for the detection of the absolute numbers of CD3^＋ , CD4^＋ , CD8^ ＋ T lymphocytes in peripheral blood. And then,the percentages of CD3 ^＋ , CD4^ ＋ , CD8 ^＋ T lymphocytes in the CD45^ ＋ cells and the ratio of CD4/CD8 were calculated. Results Sixteen-five （65.66%） cases were treated with lamivudine （ 3TC）/zidovudine （ AZT）/nevirapine （ NVP）, and 16 （ 16. 16% ）, 8 （ 8.08% ） and 10 （ 10. 10% ） cases were treated with 3TC/stavudine （ D4T）/NVP,3TC/AZT/efavirenz （EFV） and 3TC/AZT/lpv-rtv （LPV/r） ,respectively. The median of the ratio of CD4/CD8 were 0. 39,0. 51,0. 61,0. 65,0. 70,0. 73 and 0. 76 in M3 ,M6,M12,M18, M24,M30 and M36, respectively which were siguificantly higher than that in DO （0. 19） （ Z values were -5. 158, -7. 375, - 9. 078, - 8. 853, - 8. 373, - 5. 845 and - 5. 844 respectively, P 〈 0. 1300）. The median of CD4% were 16. 92% ,22. 70% ,25.54% ,26. 66% ,27.99% ,30. 36% and 29. 30% respectively in M3,M6, M12, M IS, M24, M30 and M36 respectively,which were also higher significantly than that in DO （9. 92%） （Zvalues were -5.268, - 7. 568, - 9. 496, - 9. 171, - 8. 760, - 6. 190 and -5.964 respectively, P 〈 0. 000） . In addition, the median of the absolute numbers of CD4^ ＋ T lymphocytes in peripheral blood were 631,813,1050,946,1057,1166 and 894 cells/mm^3 respectively in M3, M6, M12, M18, M24, M30 and M36, which were higher significantly th

关 键 词：儿童 HIV 获得性免疫缺陷综合征 抗逆转录病毒治疗 高效 T淋巴细胞 

分 类 号：R686[医药卫生—骨科学]