CD4^+T淋巴细胞及总淋巴细胞变化对艾滋病合并结核病的预测价值研究  

Predictive Value of CD4^+T Lymphocyte Count and Total Lymphocyte Count in Patients with AIDS Complicated with Tuberculosis

作　　者：张海丛[1] 王超[1] 郭立杰[1] 刘志权[1] 叶立红[1] 王玉泽[1] ZHANG Hal-tong;WANG Chao;GUO Li-jie;LIU Zhi-quan;YE Li-hong;WANG Yu-ze(Department of Laborato-ry Pathology-,the Fit~h Hospital of Shijiazhuang,Shijiazhuang 050021,China)

机构地区：[1]石家庄市第五医院检验科病理室,石家庄050021

出　　处：《临床误诊误治》2018年第10期86-89,共4页Clinical Misdiagnosis & Mistherapy

基　　金：河北省医学科学研究重点课题计划(20160787)

摘　　要：目的探讨CD4^+T淋巴细胞数、总淋巴细胞数变化对艾滋病(acquired immunodeficiency syndrome,AIDS)合并结核病的预测价值。方法选取2016年8月—2017年8月我院收治的88例AIDS患者,将其中31例合并结核病者纳入结核组,57例未合并结核病者纳入非结核组。比较两组血总淋巴细胞、CD4^+T淋巴细胞水平,分析患者CD4^+T淋巴细胞与总淋巴细胞数的相关性,并绘制受试者特征(receiver operating characteristic,ROC)曲线分析二者联合检测对合并结核病的预测价值。结果结核组CD4^+T淋巴细胞数和总淋巴细胞数均显著低于非结核组,差异均有统计学意义(t=-4. 430,P <0. 001; t=-4. 540,P <0. 001); 88例患者CD4^+T淋巴细胞数为(169. 10±21. 59)/μl,总淋巴细胞数为(1116. 74±79. 18)/μl,二者呈正相关(r=0. 591,P <0. 001)。ROC曲线分析显示,CD4^+T淋巴细胞数低于104. 50/μl、总淋巴细胞数低于995. 00/μl对合并结核病具有较好的预测价值。结论 AIDS患者无论是否合并结核病,CD4^+T淋巴细胞数与总淋巴细胞数均呈正相关,但是合并结核病者二者明显降低,且二者对合并结核病有相近的预测价值。Objective To explore the predictive value of CD4 ＋T lymphocyte count and total lymphocyte count （TLC） in patients with AIDS complicated with tuberculosis. Methods Eightyeight AIDS patients admitted to our hospital fiom August 2016 to August 2017 were selected as research subjects, including 31 cases with tubereulo- sis as tuberculosis group and 57 cases without tuberculosis as nontuberculosis group. The levels of TLC and CD4 ＋ T lymphocytes were compared between the two groups. The correlation between CD4 ＋ T lymphocyte and TLC was com- pared. In addition, the receiver operating characteristic （ PtOC ） curve was delineated to analyze the predictive value of CD4 ＋ T lymphocyte count and TLC for AIDS patients complicated with tuberculosis. Results CD4 ＋ T lymphocyte count and TLC in the tuberculosis group were significantly lower than those in the non-tuberculosis group （t = -4. 430, P 〈 0. 001 ; t = - 4. 540, P 〈 0. 001 ）. The C D4 ＋ T lymphocyte count of all 88 patients was （ 169.10 _＋ 21.59）/-xl, which was positively correlated （r =0. 591, P 〈0. 001 ） with TLC （ 1116.74 _＋79.18）//＊1. IROC cmw-e analysis showed that CD4 ＋ T lymphocyte count less than 104.50/I.tl and TLC less than 995.00/I.tl is a good predictor of tuberculosis. Conclusion The CD4 ＋ T lymphocyte count was positively correlated with TLC in AIDS patients with or without tuberculosis. However, CD4 ＋ T lymphocyte count and TLC in AIDS patients with tuberculosis were significantly reduced, and both had similar predictive value for those AIDS patients complicated with tuberculosis.

关 键 词：获得性免疫缺陷综合征 结核 CD4阳性T淋巴细胞 淋巴细胞计数 

分 类 号：R512.91[医药卫生—内科学]