AIDS病人治疗前后病毒载量、T淋巴细胞亚群计数、γ-GT活性、LACT浓度的动态分析  

A dynamic analysis of viral load,T-lymphocyte count,γ-GT and LACT in HIV/AIDS patients during treatment

作　　者：苏国生[1] 李山[2] 秦雪[2] 罗晓璐[1] 黄宛虹 韦善求 苏汉珍[1] 罗顺达[1] 刘泽端[1] 

机构地区：[1]广西南宁市第四人民医院检验科广西艾滋病临床治疗中心,南宁530023 [2]广西医科大学第一附属医院检验科,南宁530021

出　　处：《中国艾滋病性病》2014年第6期398-402,共5页Chinese Journal of Aids & STD

基　　金：2011年广西南宁市重大科技资助项目(201109047C);2012年广西南宁市科技项目资助课题(20123161);(20123164)~~

摘　　要：目的动态分析艾滋病(AIDS)病人治疗前后病毒载量、T淋巴细胞亚群计数、血清γ谷氨酰转移酶(γ-GT)活性和乳酸(LACT)浓度的变化情况。方法选取2008年12月至2012年3月,在广西艾滋病临床治疗中心(南宁)住院治疗的385例AIDS病人作为研究对象,根据病人治疗前病毒载量和合并症进行分组,采用实时荧光定量PCR、流式细胞术、全自动生化分析等技术,对AIDS病人治疗前后各组的病毒载量、T淋巴细胞亚群计数、血清γ-GT活性、LACT浓度的检测结果进行动态分析。结果 385例AIDS病人中,单纯HIV感染171例(44.42%);合并结核病感染180例(46.75%);合并马尔尼非青霉菌(PSM)感染34例(8.83%)。病毒载量高值组为330例(85.71%),低值组55例(14.29%)。病毒载量高值组治疗前与治疗后3个月各项指标检测结果比较,除血清LACT浓度有差异外,其余各项指标差异均无统计学意义(P>0.05);病毒载量低值组治疗前与治疗后3个月检测结果比较,CD+3、CD+4T淋巴细胞计数及血清LACT浓度差异均有统计学意义(P<0.05)。单纯HIV感染组,治疗前与治疗后3个月比较,除血清LACT浓度差异具有统计学意义(P<0.05)外,其余各项指标变化的差异均无统计学意义(P>0.05);HIV合并结核感染组,治疗前与治疗后3个月、6个月比较,除血清LACT浓度差异有统计学意义(P<0.05)外,其余各项指标差异均无统计学意义(P>0.05)。而治疗后3个月和6个月结果比较,所有指标检测结果差异均无统计学意义(P>0.05);HIV合并PSM感染组,治疗前与治疗后3个月比较,CD+3、CD+4T淋巴细胞计数以及血清LACT浓度差异均具有统计学意义(P<0.05),CD+8T淋巴细胞计数、血清γ-GT活性差异均无统计学意义(P>0.05)。结论动态观察AIDS病人病毒载量、T淋巴细胞亚群计数与γ-GT、LACT均有不同变化,对病人病情发展、疗效观察及用药治疗具有重要的临床意义,值得探索研究。Objective To investigate dynamic changes of viral load, T lymphocyte subsets counts, serum gamma glutamyl transferas （y-GT） and LACT in HIV/AIDS patients before and after treatment. Methods The study enrolled 385 HIV/AIDS patients treated in Guangxi AIDS clinical treatment center （Nanning） between December 2008 and March 2012. Patients were grouped according to baseline viral loads and complications. Real-time fluorescent quantitative PCR, flow cytometry, fully automatic biochemistry were used to detect viral loads, T lymphocyte subsets counts, serum gamma y-GT and LACT, and dynamic changes were analyzed. Results Of 385 AIDS patients, 171 （44.42%） were infected only HIV, 180 （46.75%） coinfected with tuberculosis （TB）, and 34 （ 8.83 %） coinfected with Penicillium marneffei （PSM）. There were 330 （85.71%） patients in high viral load group, and 55 （14.29%） patients in low viral load group. There were no significant differences in pa rameters except LACT in high viral load group before and after 3 months of treatment （P〈 0.05）. There were significant differences in CD＋, CD＋ T lymphocytes and concentration of LACT in low viral loadgroup before and after 3 months of treatment. （P（0.05）. There were no significant differences in parameters except LACT in HIV infection only group before and after 3 months of treatment （P） 0.05）. Compared with baseline data, there were no significant differences in parameters except LACT （P〈0.05） in HIV/TB eoinfection group after 3 and 6 months of treatment. There were no significant differences in all parameters between 3 months and 6 months of treatment （P〉 0.05）. In HIV/PSM coinfection group, CDI and CDI T lymphoeytes had significant changes （P〈 0.05）, and serum concentration of LACT, CD8＋ T lymphocytes and serum gamma GT had no significant changes before and after 3 months of treatment （P〉 0.05）. Conclusions Dynamic observation of viral loads, T lymphocyte subsets and gamma GT, LACT in HIV/AIDS patients

关 键 词：艾滋病 病毒载量 T淋巴细胞亚群 γ谷氨酰转移酶(γ-GT) 乳酸(LACT) 

分 类 号：R512.91[医药卫生—内科学]