HIV/AIDS合并慢性肝炎肝内静脉及脾静脉超声与CD4^+T淋巴细胞数相关性的研究  

Correlation between Ultrasonographic Features of Patients with HIV/AIDS Combined with Chronic Viral Hepatitis and CD4^+T Lymphocyte Count

作　　者：曹芬[1] 叶庆[2] 

机构地区：[1]成都市传染病医院超声科,成都610061 [2]成都市传染病医院中医科,成都610061

出　　处：《华西医学》2014年第11期2077-2080,共4页West China Medical Journal

基　　金：四川省卫生厅科研计划项目(110077)~~

摘　　要：目的探讨HIV/AIDS合并慢性病毒性肝炎在CD4+T淋巴细胞计数不同免疫时期肝内静脉及脾静脉的超声改变。方法选择2010年1月-2013年10月50例合并HIV/AIDS慢性病毒性肝炎患者作为病例组,50例单纯性慢性病毒性肝炎患者作为对照组。观察病例组(按CD4+T淋巴细胞计数的不同免疫时期)与对照组肝内静脉及脾静脉的超声改变。结果病例组肝内静脉及脾静脉在不同CD4+T淋巴细胞计数的免疫时期有超声异常改变,主要表现在门静脉及脾静脉远端走行不清,内径增宽,血流速减慢,血流频谱起伏消失、平直;肝静脉远端走行不清,血流频谱低矮三相型、负相型、空窗消失。CD4+T细胞数>300/mm3组与对照组之间肝内静脉、脾静脉超声观察指标比较,差异无统计学意义(P>0.05);CD4+T细胞数100~200/mm3组的脾静脉内径、肝静脉血流频谱与对照组差异有统计学意义(P<0.05);CD4+T细胞数<100/mm3组除肝静脉走行异常发生率差异无统计学意义外(P>0.05),其余异常情况发生率与对照组比较差异均有统计学意义(P<0.05)。结论 HIV/AIDS合并慢性病毒性肝炎肝内静脉及脾静脉超声异常改变随着CD4+T细胞计数下降更为明显,综合考虑肝内静脉及脾静脉超声各项指标的变化有助于临床评估HIV/AIDS合并慢性病毒性肝炎的病情发展。Objective To investigate the ultrasonic changes of hepatic veins and splenic veins during various immune stages with different CD4＋T lymphocyte count. Methods Fifty AIDS/HIV patients with chronic viral hepatitis treated between January 2010 and October 2013 were designated as the case group, and another 50 patients with simple chronic viral hepatitis were regarded as the controls. For patients in the case group, we observed their ultrasonic changes of hepatic and splenic veins during various immune stages with different CD4＋T lymphocyte count. The results of observation and clinical laboratory analysis were compared. Results Abnormal ultrasonic changes were detected in the liver in various immune stages based on the CD4＋T lymphocyte count, and the main manifestations of these changes included unclear portal and splenic vein distal direction, wide diameter, slowed blood flow velocity, and disappearance of fluctuations of blood flow spectrum; and unclear hepatic vein distal direction, low and three-phase, and negative blood flow spectrum with the disappearance of windows were also detected. There were no statistical differences between the case group and the control group when the CD4＋T cell count was over 300/mm3, and a few indexes were significantly different when the CD4＋T cell count was between 100 and 200/mm3. However, the differences of almost all indexes were significant when the CD4＋T cell count was below 100/mm3. Conclusions Patients with HIV/AIDS combined with chronic viral hepatitis have ultrasonographic abnormalities of intrahepatic and splenic veins, which is more obvious as the CD4＋T cell count declines. Overall consideration of intrahepatic vein and splenic vein ultrasonic indicators helps clinical assessment of disease development in patients with HIV/AIDS combined with chronic viral hepatitis.

关 键 词：HIV/AIDS合并慢性肝炎 超声检查 肝内静脉及脾静脉 CD4+T淋巴细胞计数 

分 类 号：R512.91[医药卫生—内科学]