HIV/HBV感染患者血清ALT和TGF-β1与TNF-α水平变化  

Changes of serum ALT, TGF-β1 and TNF-α in patients with HIV/HBV co-infection

作　　者：李忠琴[1] 李鑫 李成忠[1] 陆小琴[1] 雷娇娇 LI Zhong-qin;LI Xin;LI Cheng zhong;LU Xiao-qin;LEI Jiao-jiao(Ya'an Vocational and Technical College,Ya'an,Sichuan 625000,China)

机构地区：[1]雅安职业技术学院药学与检验学院,四川雅安625000 [2]雅安职业技术学院附属医院检验科,四川雅安625000

出　　处：《中华医院感染学杂志》2020年第22期3448-3452,共5页Chinese Journal of Nosocomiology

基　　金：全国职业教育科研规划基金资助项目(2019QZJ284);雅安职业技术学院高等教育人才培养质量和教学改革基金资助项目(2018-100-13)。

摘　　要：目的分析人类免疫缺陷病毒/乙型肝炎病毒(HIV/HBV)合并感染患者病毒载量与血清丙氨酸氨基转移酶(ALT)、转化生长因子-β1(TGF-β1)、肿瘤坏死因子-α(TNF-α)水平间的关系。方法回顾性分析2017年1月-2019年6月在雅安职业技术学院附属医院确诊的83例单纯HIV患者和62例HIV/HBV合并感染患者临床资料。抗病毒治疗前,采用聚合酶链式反应(PCR)检测血清中HIV RNA和HBV DNA病毒载量;采用全自动生化分析仪检测ALT水平;酶联免疫吸附实验(ELISA)法检测血清TGF-β1和TNF-α水平;流式细胞仪检测外周静脉血CD4+T淋巴细胞计数;采用Logistic回归分析影响HIV/HBV合并感染的独立因素;受试者工作特征曲线(ROC)分析血清ALT、TGF-β1和TNF-α对HIV/HBV合并感染的预测价值;Pearson相关性分析ALT、TGF-β1和TNF-α与HIV/HBV合并感染患者病毒载量之间的相关性。结果 ALT(OR=2.113,P=0.027)、TGF-β1(OR=2.026,P=0.039)以及TNF-α(OR=1.978,P=0.047)水平升高为影响HIV/HBV合并感染的独立因素;血清ALT、TGF-β1、TNF-α水平以及三者联合检测对HIV/HBV合并感染的预测价值依次为0.865、0.849、0.787和0.954;HIV/HBV合并感染患者HIV RNA水平与ALT、TGF-β1、TNF-α水平呈正相关关系(r=0.641,0.565,0.576;P<0.05),HBV DNA水平与ALT、TGF-β1、TNF-α水平呈正相关关系(r=0.756,0.760,0.604;P<0.05)。结论 HIV/HBV合并感染患者病毒载量与血清ALT、TGF-β1、TNF-α水平呈正相关关系。OBJECTIVE To observe the correlation between the viral loads of the patients with coinfection of human immunodeficiency virus/hepatitis B virus(HIV/HBV) and the levels of serum alanine aminotransferase(ALT), transforming growth factor-β1(TGF-β1) and tumor necrosis factor-α(TNF-α). METHODS Totally 83 patients with single HIV infection and 62 patients with HIV/HBV coinfection who were confirmed in Ya’an Vocational and Technical College from Jan 2017 to Jun 2019 were enrolled in the study, and the clinical data were retrospectively analyzed. The viral loads of serum HIV DNA and HBV DNA were detected by using polymerase chain reaction(PCR) before the antiviral therapy, the ALT level was detected by means of by automatic biochemical analyzer, the levels of serum TGF-β1 and TNF-α were detected by enzyme linked immunosorbent assay(ELISA), the peripheral blood CD4+ T lymphocyte counts were determined by flow cytometry. Logistic regression analysis was performed for the independent factors for the HIV/HBV coinfection, receiver operating characteristic(ROC) curve analysis was carried out for the value of serum ALT, TGF-β1 and TNF-α in prediction of the HIV/HBV infection, and Pearson correlation analysis was performed for the correlation between the ALT, TGF-β1 and TNF-α and the viral loads of the patients with HIV/HBV coinfection. RESULTS The ALT(OR=2.113,P=0.027), TGF-β1(OR=2.026,P=0.039) and TNF-α(OR=1.978,P=0.047) were the independent influencing factors for the HIV/HBV coinfection. The values of the serum ALT, TGF-β1, TNF-α and the joint detection of the three indexes were respectively 0.865, 0.849, 0.787 and 0.954 in prediction of the HIV/HBV coinfection. The HIV RNA level of the patients with HIV/HBV coinfection was positively correlated with the levels of ALT, TGF-β1 and TNF-α(r=0.641,0.565,0.576;P<0.05);the HBV DNA level was positively correlated with the levels of ALT, TGF-β1 and TNF-α(r=0.756,0.760,0.604;P<0.05). CONCLUSION The viral load of the patients with HIV/HBV coinfection is positively

关 键 词：人类免疫缺陷病毒 乙型肝炎病毒 丙氨酸氨基转移酶 转化生长因子-Β1 肿瘤坏死因子-α 

分 类 号：R512.91[医药卫生—内科学]