芪灵汤联合高效抗逆转录病毒疗法对HIV/AIDS患者Th17和Treg细胞表达水平的影响  

Effect of Qiling Decoction Combined HAART on Expression Levels of Treg Cells and Th17 in HIV/AIDS Patients

作　　者：许文芳[1] 吴勇[1] 潘国绍 钟建平[1] 兰少波[1] 陈雪芳[1] 吕秋琼[1] 

机构地区：[1]浙江省绍兴市第六人民医院检验科,浙江312000 [2]浙江省绍兴市疾病预防控制中心,浙江312000

出　　处：《中国中西医结合杂志》2014年第2期157-161,共5页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：浙江省绍兴市重点科技计划项目(No.2011A23016)

摘　　要：目的探讨芪灵汤联合高效抗逆转录疗法（HAART）对HIV／AIDS患者外周血Thl7和Treg细胞表达水平的影响。方法将55例HIV／AIDS患者随机分成HAART治疗组28例和联合治疗组27例，并选取21例HlV阴性患者为健康对照组。HAART治疗组给予HAART治疗，联合治疗组给予芪灵汤联合HAART治疗，观察24周。同时根据治疗前外周血CD4＋T细胞计数水平，将HIV／AIDS患者分为3层，第一层：1～100个／μL；第二层：101～200个/μL；第三层：201～350个/μL，运用流式细胞术（FCM）检测HIV，AIDS患者治疗前基线、治疗4、12、24周时间点、健康对照组外周血Thl7、Treg细胞的表达水平及CD4＋T细胞数目。结果与健康对照组比较，HlV／AIDS患者外周血中Thl7细胞基线表达水平及CD4＋T细胞数显著降低，Treg细胞基线表达水平则升高，差异有统计学意义（P〈0．01）；与同组治疗前比较，HAART治疗组与联合治疗组治疗4、12和24周时CD4＋T细胞计数均升高，差异有统计学意义（P〈0．05，P〈0．01）。不同CD4＋T细胞水平，两组患者有效率差异无统计学意义（P〉0．05）。各时间点上，HAART治疗组与联合治疗组Thl7细胞、Treg细胞表达水平无统计学意义（均P〉0．05）。与HAART治疗组比较，治疗24周后，联合治疗组Thl7／Treg比例显著升高，差异有统计学意义（U=2．135，P=0．038）。结论芪灵汤能够改善Thl7/Treg细胞免疫平衡，这可能是芪灵汤提高HlV／AIDS患者免疫功能的机制之一。Objective To explore the effect of Qiling Decoction （QD） combined highly active an- tiretroviral treatment （HAART） on expression levels of peripheral blood Th17 and Treg cells in HIV/AIDS patients. Methods Totally 55 HIV/AIDS patients were randomly assigned to the treatment group （28 ca- ses） and the combination group （27 cases）. Besides, 21 HIV negative patients were recruited as the healthy control group. Those in the treatment group received HARRT alone, while those in the combina- tion group received HAART combined QD. The observation lasted for 24 weeks. Meanwhile, according to peripheral blood CD4 ＋ T cell counts before treatment, HIV/AIDS patients were assigned to three sub- groups. For patients in subgroup 1, 1 cells/μL 〈 CD4＋ T cell counts ≤100 cells/μL For patients in sub- group 2,101 cells/μL 〈 CD4 ＋ T cell counts ≤200 cells/μL For patients in subgroup 3,201 cells/μL 〈 CD4 ＋ T cell counts ≤350 cells/μL. Expression of peripheral blood Th17 and Treg cells, and number of CD4 ＋ T cell counts were detected using flow cytometry （FCM）in HIV/AIDS patients at the pre-treatment baseline, week 4, 12, and 24, as well as those in the healthy control group. Results Compared with the healthy control group, CD4 ＋ T cell counts and the baseline expression level of Th17 cells in the peripheral blood of HIV/AIDS patients significantly decreased, the expression level of Treg cells significantly increased（P 〈0.01 ）.Compared with before treatment in the same group, CD4 ＋ T cell counts all increased at week 4, 12, and 24 in the two treatment groups, showing statistical difference （P 〈0.05, P 〈0.01 ）. There was no statistical difference in the effective rate at various CD4＋ T cell levels between the two groups （P 〉0.05）. There was no statistical difference in expression levels of Th17 and Treg cells between the combination group and the treatment group at any time point （all P 〉0.05）. The Th17/Treg ration significantly increased in the combinatio

关 键 词：芪灵汤 获得性免疫缺陷综合症 人类免疫缺陷病毒 辅助性T细胞17 调节性T细胞 CD4+T细胞 

分 类 号：R512.91[医药卫生—内科学]