HIV/AIDS患者外周血CD4~＋T细胞亚群及中性粒细胞CD64的变化及临床意义  

The changes and the clinical significance of CD4^+T cell subsets and neutrophil CD64 in peripheral blood of HIV/AIDS patients

作　　者：冯倩[1] 任伟宏 仝岩 赵航 李文博[1] 李彦卿 冯慧洁[1] 

机构地区：[1]河南中医学院研究生处,郑州450000 [2]第一附属医院检验科

出　　处：《免疫学杂志》2015年第7期595-598,607,共5页Immunological Journal

基　　金：河南省教育厅自然科学研究项目(13A360564)

摘　　要：目的探讨HIV/AIDS患者外周血中CD4+T细胞亚群及中性粒细胞CD64的变化及临床意义。方法筛选2014年5月至9月河南中医学院第一附属医院艾滋病临床研究中心收治的47例HIV/AIDS患者,根据CD4+T淋巴细胞数将其分为A组(CD4≤350 cell/μl)23人,B组(CD4>350 cell/μl)24人,同期选取健康对照组20人。用流式细胞仪(FCM)检测3组人员外周血中CD4+T细胞亚群(Th1、Th2、Th17、Treg)及中性粒细胞表面CD64表达水平,用SPSS17.0软件分析数据。所有数据用中位数表示,2组间比较采用Mann-Whitney检验,相关性分析采用Spearman秩相关。结果 A组和健康对照组Th1细胞(CD4+IFN-γ+)百分比均高于B组(P=0.040,P=0.028);A组Th2细胞(CD4+IL4+)百分比高于B组(P=0.015);A和B组Treg细胞(CD4+CD25+FOXP3+)百分比均高于健康对照组(P均<0.05),A组Treg细胞高于B组(P=0.001);Th17细胞以及中性粒细胞表面CD64的表达量3组比较差异无统计学意义;Treg细胞与CD4+T细胞呈负相关(r=-0.734,P=0.000),Treg细胞与Th1/Th2比值呈负相关(r=-0.300,P=0.015)。结论 HIV/AIDS患者CD4+T细胞亚群之间的平衡失调,调节性T细胞处于优势状态,CD4+T细胞亚群变化可作为HIV/AIDS患者疾病进展的动态监测指标。CD64是机体急性炎症感染的一个重要参考指标,但在HIV/AIDS患者中变化不明显。This study aimed to explore the changes and clinical significance of CD4＋T cell subsets （Thl, Th2, Thl7, Treg） and neutrophil CD64 （CD16＋CD32＋CD64＋） in peripheral blood of HIV/AIDS patients. According to the amount of CD4＋T cells, the patients with HIV/AIDS were divided into group A （CD4 ≤350 cells/Ixl） and group B （CD4〉350 cells/μl）, with 20 healthy persons as the healthy control group. The expressions of Thl, Th2, Thl7, Treg and CD16＋CD32＋CD64＋ cells were analyzed by flow cytometry. We found that the percentage of Thl cells in group A and healthy control group was higher than that of group B （P=0.040, P=0.028）, and the percentage of Th2 cells in group A was higher than that of group B （P=0.015）; the percentage of Treg cells in group A and group B was higher than that of healthy control group （P〈0.05）, which of group A was higher than that of group B （P=0.001）. In addition, the percentages of Thl7 and CD16＋CD32＋CD64＋ cells showed no statistically significant between the three groups. Correlation analysis showed that there was inverse correlation between Treg cells and CD4＋T cells （r=-0.734, P=- 0.000）, as well as between Treg cells and the ratio of Th1/Th2 （r=-0.300, P=0.015）. Our results indicated that the balance betweenCD4＋T subsets is broken in HIV/AIDS patients, and Treg cells are in a dominant position, thus the changes of CD4＋T subsets can be the dynamic monitoring indicator during the progression of HIV/AIDS. CD64 is an important reference index when people suffered acute inflammation, but do not play crucial role in HIV/AIDS patients.

关 键 词：CD4+T细胞亚群 中性粒细胞 CD64 人类获得性免疫缺陷病毒 

分 类 号：R512.91[医药卫生—内科学]