无症状期人类免疫缺陷病毒感染者外周血CD_4^+T淋巴细胞计数与总淋巴细胞计数的相关性分析  

Correlation between CD_4^+ T Lymphocyte Count and Total Lymphocyte Count in HIV Infectors in Asymptomatic Stage

作　　者：金艳涛[1] 郭会军[1] 蒋自强[1] 

机构地区：[1]河南中医学院第一附属医院艾滋病临床研究中心,河南省郑州市450000

出　　处：《中国全科医学》2013年第26期3081-3083,共3页Chinese General Practice

基　　金：科技部国际合作项目资助(2007DFB31610);国家中医药管理局中医药重点学科建设项目(国中医药发〔2009〕30号);郑州市科技创新团队建设项目(10CXTD140)

摘　　要：目的探讨无症状期人类免疫缺陷病毒(HIV)感染者外周血CD4+T淋巴细胞计数与总淋巴细胞计数(TLC)的相关性。方法纳入2011年河南中医学院第一附属医院艾滋病临床研究中心组织开展的一项国际合作课题患者入组时的实验室数据,计算无症状期HIV感染者CD4+T淋巴细胞计数与TLC的相关系数,并绘制受试者工作特征(ROC)曲线判断TLC代替CD4+T淋巴细胞计数的最佳临界值及计算其灵敏度、特异度、阳性预测值、阴性预测值和一致率。结果共纳入分析了98例患者的实验室资料。患者外周血CD4+T淋巴细胞计数与TLC呈正相关(r=0.548,P<0.01)。用TLC<1 300×106个/L预测CD4+T淋巴细胞计数<200×106个/L的灵敏度为43.48%,特异度为96.00%,阳性预测值为76.92%,阴性预测值为84.71%,一致率为83.67%;TLC<2 000×106个/L预测CD4+T淋巴细胞计数<350×106个/L的灵敏度为66.10%,特异度为66.67%,阳性预测值为75.00%,阴性预测值为56.52%,一致率为66.33%;TLC<2 100×106个/L预测CD4+T淋巴细胞计数<500×106个/L的灵敏度为67.82%,特异度为72.73%,阳性预测值为95.16%,阴性预测值为22.22%,一致率为68.37%。结论无症状期HIV感染者外周血CD4+T淋巴细胞计数与TLC相关。按照现行的治疗无症状期HIV感染者的CD4+T淋巴细胞计数标准及指南,建议当患者TLC<2 000×106个/L时尽早核查CD4+T淋巴细胞计数,以便尽早让HIV感染者开始抗病毒治疗。Objective To analyze the correlation between CD4＋ T lymphocyte count and in total lymphocyte count （TLC） in HIV infectors in asymptomatic stage. Methods The coefficient correlation of the CD4＋ T lymphocyte count and TLC were computed in asymptomatic HIV - infectors, and receiver operating characteristic （ ROC ） curve drawn to judge the optimal cutoff values of TLC replacing CD4＋ T lymphocyte count and calculate its sensitivity, specificity, positive predictive value （PPV） , negative predictive value （NPV） and concordance rate. Results A significant positive linear correlation was noted be- tween TLC and CD4＊ T lymphocyte count （ r = 0. 548, P 〈 0. 01 ）. When TLC 〈 1 300 ×106 eell/L predicting CD4＋ T 〈 200× 106 cell/L, the sensitivity was 43.48% , specificity 96. 00% , PPV 76. 92%, NPV 84. 71% and concordance rate 83.67%. When TLC 〈2 000 × 106 eell/L predicting CD4＋ T 〈350 × 106 cell/L, the sensitivity was 66. 10%, specificity 66. 6%, PPV 75.00%, NPV 56. 52% , concordance rate 66. 33%. When TLC 〈 2 100 × 106 cell/L predicting CD4＋ T 〈 500 × 106 cell/L, the sensitivity was 67. 82%, specificity 72. 73%, PPV 95. 16%, NPV 22. 22%, concordance rate 68.37%. Conclusion Peripheral CD4＋ T lymphocyte count are correlated with TLC in asymptomatic HIV infectors. It is suggested that CD4＋ T lympho- cyte count should be determined as soon as possible when TLC 〈2 000 × 106 cell/L, to start antiviral therapy earlier for HIV in- fectors.

关 键 词：HIV感染 CD4细胞计数 淋巴细胞计数 相关性 

分 类 号：R512.91[医药卫生—内科学] R331.125[医药卫生—临床医学]