347例HIV/AIDS患者外周血免疫细胞表达水平的临床意义  

Expression level and clinical significance of immune cells in peripheral blood of 347 HIV/AIDS patients

作　　者：丁建平[1] 朱春玲[2] 侯远沛 DING Jian-ping;ZHU Chun-ling;HOU Yuan-pei(Chinese Medicine Hospital of Dongtai,Dongtai 224200,Jiangsu,China)

机构地区：[1]东台市中医院检验科,江苏东台224200 [2]徐州市传染病医院检验科

出　　处：《中国校医》2020年第9期684-688,共5页Chinese Journal of School Doctor

摘　　要：目的分析HIV/AIDS患者外周血免疫细胞的表达水平随CD4^+淋巴细胞数量、白蛋白含量、HIV-RNA载量以及合并感染的变化情况,探讨其检测的临床意义。方法回顾性分析347例HIV/AIDS患者外周血的临床资料,对CD4^+、CD8^+、B淋巴细胞、自然杀伤细胞(NK)的绝对数、白蛋白(ALB)含量、HIV-RNA载量以及梅毒螺旋体抗体(TP)、乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV)抗体的检测结果进行统计学分析。结果CD4^+含量降低组的HIV/AIDS患者CD8^+、B、NK细胞的表达水平低于正常组患者(P<0.01),CD8^+、NK、B细胞的含量与CD4^+数量呈正相关(P<0.05);白蛋白含量降低组的HIV/AIDS患者CD4^+、CD8^+、B、NK细胞的表达水平低于正常组的患者(P<0.01),白蛋白含量与CD4^+、CD8^+、B、NK细胞的数量呈正相关(P<0.01);HIV-RNA阳性患者CD4^+、CD8^+、B、NK细胞的表达水平低于阴性患者(P<0.01),合并感染率为27.9%,高于阴性患者22.5%(P<0.05),HIV-RNA载量与CD4^+、B淋巴细胞含量呈负相关(P<0.05)。结论CD8^+、B、NK细胞的表达水平以及合并感染率与疾病的进展密切相关,对于新发现的HIV/AIDS患者,同时检测血清中TP/HBV/HCV抗体,能准确地掌握合并感染情况,有利于实施个体化治疗方案。Objective To analyze the expression levels of immune cells in peripheral blood changed with the number of CD4^+lymphocytes,albumin content,HIV-RNA load and co-infection of the HIV/AIDS patients,and explore the clinical significance of their detections.Methods Based on the retrospective analysis of the data of peripheral blood of 347 HIV/AIDS patients,the detection results of the absolute numbers of peripheral blood CD4^+,CD8^+,B lymphocytes,natural killer cells(NK),albumin(ALB)content,HIV-RNA load,and presence of Treponema pallidum(TP)antibody,hepatitis B virus(HBV)antibody,and hepatitis C virus(HCV)antibody were statistically analyzed.Results The expression levels of CD8^+,B lymphocytes,and NK cells in the HIV/AIDS patients with reduced CD4^+levels were lower than those in the normal group(P<0.01),and the contents of CD8^+,NK,and B cells were positively correlated with CD4^+numbers(P<0.05).The expression levels of CD4^+,CD8^+,B lymphocytes and NK cells in HIV/AIDS patients of the reduced albumin group were lower than those in the normal group(P<0.01),and the numbers of CD4^+,CD8^+,B and NK cells were positively correlated with the albumin content(P<0.01).The expression levels of CD4^+,CD8^+,B lymphocytes,and NK cells in the HIVRNA positive patients were lower than those in the HIV-RNA negative patients(P<0.01),and the combined infection rate in the HIV-RNA positive patients was 27.9%,which-was higher than 22.5%in the HIV-RNA negative patients(P<0.05).The HIV-RNA load-was negative correlated with CD4^+and B lymphocyte contents(P<0.05),while it had no correlation with the contents of CD8^+and NK cells(P>0.05).Conclusion The expression levels of CD8^+,B lymphocytes,NK cells,and co-infection rate are closely related to the disease progression.For the newly discovered HIV-infected patients,the simultaneous detection of TP\HBV\HCV antibodies in the serum can help us accurately grasp the patient’s combined infection,which is conducive to the implementation of personalized treatment programs.

关 键 词：人类免疫缺陷病毒 获得性免疫缺陷综合征 合并感染 

分 类 号：R446.1[医药卫生—诊断学] R512.91[医药卫生—临床医学]