人类免疫缺陷病毒感染者恒定型自然杀伤性T淋巴细胞的表达意义  

The clinical significance of invariant natural killer T cells in patients with human immunodeficiency virus infection

作　　者：邹美银[1] 凌勇武[1] 卞兆连 居林玲 汪美华[1] 顾丽华[1] Zou Meiyin, Ling Yongwu, Bian Zhaolian, Ju Linlin, Wang Meihua, Gu Lihua(Department of Infectious Diseases, Third People＇s Hospital of Nantong, Nantong 226006, Chin)

机构地区：[1]南通市第三人民医院感染科,226006 [2]南通市肝病研究所

出　　处：《中华传染病杂志》2018年第4期222-226,共5页Chinese Journal of Infectious Diseases

基　　金：南通市社会事业创新与示范计划项目（HS2014084）;南通市科技计划项目（GJZ16102）

摘　　要：目的探讨HIV感染者外周血恒定型自然杀伤性T细胞（invariant nature killer T，iNKT）表达水平的变化。方法选择2016年6月至2017年7月就诊的HIV感染者101例作为研究对象，其中无症状期52例，艾滋病期49例。采用流式细胞仪检测外周血iNKT、CD4＋ T淋巴细胞、CD8＋T淋巴细胞，并分析与HIV RNA间的关系。以健康人群12名作为健康对照组。统计学处理采用t检验或方差分析、秩和检验、χ2检验或Fisher确切概率法。结果HIV感染无症状期、艾滋病期、健康人群外周血iNKT分别为0.135%（0.066%，0.228%）、0.058%（0.034%，0.100%）和0.385%（0.205%，0.600%），差异有统计学意义（Z＝40.113，P〈0.01）；CD4＋T淋巴细胞分别为（340.82±119.26）、（72.73±61.84）和（555.17±229.43） 个/μL，差异有统计学意义（t＝113.79，P〈0.01）；CD8＋T淋巴细胞分别为（842.29±423.68）、（540.43±257.85）和（875.92±516.45） 个/μL，差异有统计学意义（t＝9.423，P〈0.01）；CD4＋/CD8＋分别为0.490（0.240，0.695）、0.120（0.030，0.210）和0.600（0.475，0.895），差异有统计学意义（Z＝53.603，P〈0.01）。iNKT在是否合并HBV、肺孢子菌肺炎、口腔真菌感染、梅毒螺旋体、潜伏性结核、EB病毒感染患者之间差异无统计学意义（Z值分别为0.244、2.325、2.393、0.168、1.183和0.454，均P〉0.05）。HIV感染者外周血iNKT与CD4＋T淋巴细胞和CD4＋/CD8＋有相关性（r值分别为0.513和0.261，均P〈0.01）；与CD8＋T淋巴细胞无相关性（r＝0.155，P＝0.126）；无症状期、艾滋病期患者iNKT与HIV RNA无相关性（r值分别为－0.113和－0.111，均P〉0.05）。结论HIV感染者外周血iNKT表达水平随着疾病的进展而下降，可在一定程度上反映免疫损伤的严重程度。ObjectiveTo explore the changes of the peripheral invariant natural killer T （iNKT） cells in patients with human immunodeficiency virus （HIV） infection. MethodsA total of 101 patients with HIV infection including 52 asymptomatic patients and 49 acquired immunodeficiency syndrome （AIDS） patients were enrolled in the study from June 2016 to July 2017. Flow cytometry was used to detect iNKT cells, CD4＋ T cells and CD8＋ T cells, and the relationship among them and HIV RNA was studied. At same time, 12 healthy persons were enrolled as control group. T test or variance analysis, rank sum test, Chi-square test and Fisher exact test were used for statistical analysis. ResultsIn HIV infected asymptomatic patients, AIDS patients and healthy controls, iNKT cells were 0.135% （0.066%, 0.228%）, 0.058% （0.034%, 0.100%） and 0.385% （0.205%, 0.600%）, respectively, and the difference was statistical significant （Z=40.113, P〈0.01）. CD4＋ T cell counts in the three groups were （340.82±119.26） cells/μL, （72.73±61.84） cells/μL and （555.17±229.43） cells/μL, respectively, and the difference was statistical significant （t=113.79, P〈0.01）; CD8＋ T cell counts in the three groups were （842.29±423.68） cells/μL, （540.43±257.85） cells/μL and （875.92±516.45） cells/μL, respectively, and the difference was statistical significant （t=9.423, P〈0.01）. Ratios of CD4＋ /CD8＋ T cells in the three groups were 0.490 （0.240, 0.695）, 0.120 （0.030, 0.210） and 0.600 （0.475, 0.895）, respectively, and the difference was statistical significant （Z=53.603, P〈0.01）. iNKT cell counts in patients with or without hepatitis B virus infection, pneumocystis pneumonia, oral mold infection, treponema pallidum, latent tuberculosis or EB virus infection were not significantly different （Z=0.244, 2.325, 2.393, 0.168, 1.183 and 0.454, respectively, all P〉0.05）. There were correlations between iNKT cells and CD4＋ T cells, CD4＋ /CD8＋ T cells （r=0.513 and 0.261

关 键 词：人类免疫缺陷病毒 CD4阳性T淋巴细胞 CD8阳性T淋巴细胞 恒定型自然杀伤性T淋巴细胞 

分 类 号：R512.91[医药卫生—内科学]