人类免疫缺陷病毒1感染者外周血CD_8^+ T淋巴细胞表面CD_(38)和人类白细胞抗原DR表达的研究  

Research on the Expression of CD_(38) and HLA-DR on the Surface of CD_8^+ T Lymphocytes of Patients Infected With Human Immunodeficiency Virus 1

作　　者：李强[1] 刘真[1] 桑锋[1] 李杰[1] 任周新[1] 邓博文[1] 李承乘 黄钦恒 徐立然[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,河南省病毒性疾病中医药防治重点实验室,河南省郑州市450000

出　　处：《中国全科医学》2015年第36期4428-4432,共5页Chinese General Practice

基　　金：国家"艾滋病和病毒性肝炎等重大传染病防治"科技重大专项"十二五"计划课题(2012ZX10004905-003-003;2012ZX10005010-001);国家中医药管理局临床科研基地科研专项(JDZX2012023);河南省高等学校青年骨干教师资助计划(2013GGJS-095);河南省基础与前沿计划项目(132300413215)

摘　　要：目的探索人类免疫缺陷病毒(HIV)-1感染者外周血CD_8^+T淋巴细胞表面CD_(38)(CD_(38)^+/CD_8^+)、人类白细胞抗原DR(HLA-DR)(HLA-DR^+/CD_8^+)表达水平的变化及其与疾病进展的关系。方法选取2012年5-8月河南省淮阳县中医院、西平县中医院、驻马店驿城区中医院、泌阳县中医院、博爱县中医院收治的经河南省疾病预防控制中心确诊的HIV-1感染者409例为HIV-1感染组,河南中医学院第一附属医院体检健康者28例为对照组。采用流式细胞仪检测外周血CD_4^+、CD_8^+T淋巴细胞计数和百分比,计算CD_4^+/CD_8^+,实时荧光定量聚合酶链式反应(RT-PCR)法检测血浆病毒载量,应用全血染色、流式细胞术检测HIV-1感染者CD_(38)^+/CD_8^+、HLA-DR^+/CD_8^+。根据CD_4^+T淋巴细胞计数分为4组:<200 cells/μl组87例、200~<350 cells/μl组119例、350~<500 cells/μl组99例、≥500 cells/μl组104例,比较不同CD_4^+T淋巴细胞计数者间CD_(38)^+/CD_8^+、HLA-DR^+/CD_8^+。结果 HIV-1感染组CD_4^+T淋巴细胞计数、百分比低于对照组,CD_8^+T淋巴细胞计数、百分比高于对照组(P<0.001);HIV-1感染组CD_4^+/CD_8^+低于对照组(P<0.001)。HIV-1感染者血浆病毒载量为(38 415±1 067)copies/ml。Pearson相关分析表明,HIV-1感染者CD_4^+T淋巴细胞计数与血浆病毒载量呈负相关(r=-0.246,P<0.001);CD_(38)^+/CD_8^+与CD_4^+T淋巴细胞计数呈负相关(r=-0.260,P<0.001);CD_(38)^+/CD_8^+与血浆病毒载量呈正相关(r=0.409,P<0.001);HLA-DR^+/CD_8^+与CD_4^+T淋巴细胞计数呈负相关(r=-0.225,P<0.001);HLA-DR^+/CD_8^+与血浆病毒载量呈正相关(r=0.378,P<0.001)。200~<350 cells/μl组、350~<500 cells/μl组、≥500 cells/μl组CD_(38)^+/CD_8^+、HLA-DR^+/CD_8^+低于<200 cells/μl组(P<0.05)。结论 HIV-1感染者CD_4^+T淋巴细胞计数、百分比降低,CD_8^+T淋巴细胞计数、百分比升高,CD_(38)^+/CD_8^+、HLA-DR^+/CD_8^+与血浆病毒载量呈正相关。CD_4^+T淋巴细胞计数、CD_8^+T淋巴细胞计数�Objective To explore the changes in the expression levels of CD_（38） and HLA- DR on the CD_8~＋ T lymphocytes surface of patients infected with HIV-1（CD_（38）~＋/CD_8~＋,HLA-DR~＋/CD_8~＋） and investigate the relation between the changes and disease progress.Methods Enrolled 409 HIV- infected patients who were definitely diagnosed in the Center for Disease Prevention and Control of Henan Province and were admitted into Huaiyang County Hospital of Traditional Chinese Medicine,Xiping County Hospital of Traditional Chinese Medicine,Yicheng District Hospital of Traditional Chinese Medicine in Zhumadian,Biyang County Hospital of Traditional Chinese Medicine and Boai County Hospital of Traditional Chinese Medicine from May to August in 2012 as HIV- 1- infected group.Also enrolled 28 people who received physical examination in the First Affiliated Hospital of Henan University of TCM as control group.Flow cytometry was employed to determine CD_4~＋ T lymphocyte count and proportion and CD_8~＋ T lymphocyte count and proportion,and CD_4~＋ /CD_8~＋ was caculated;RT- PCR was used to detect plasma viral load;the expression levels of CD_（38）~＋ /CD_8~＋ and HLA- DR~＋/CD_8~＋ were detected by whole blood staining and flow cytometry gating.According to CD_4~＋T lymphocyte count,the subjects were divided into 4 groups：200 cells/μl group（n=87）,200- 350 cells/μl（n = 119）,350- 500 cells/μl（n=99） and ≥500 cells/μl group（n = 104）.Comparison was made in the expression levels of CD_（38）~＋/CD_8~＋ and HLA- DR~＋/CD_8~＋ among the 4 groups.Results HIV- 1- infected group was lower（P〈0.001） in the count and proportion of CD_4~＋ T lymphocytes and was higher（P0.001） in the count and proportion of CD_8~＋ T lymphocytes than control group;HIV-1- infected group was lower than control group in CD_4~＋ /CD_8~＋（P0.001）.The plasma viral load of HIV- infected subjects was（38415 ±1067） copies/ml.Pearson correlation analysis showed that,in patients infected with H

关 键 词：HIV CD4阳性T淋巴细胞 CD8阳性T淋巴细胞 HLA抗原 

分 类 号：R512.91[医药卫生—内科学]