不同分期HIV感染者免疫球蛋白Ig、T淋巴细胞亚群的表达及与HIV RNA的相关性  

Correlation Between Expression of Ig,T Lymphocyte Subsets and HIV RNA in HIV-infected Patients with Different Stages

作　　者：杨秀丽[1] 杨凤美[1] Yang Xiuli;Yang Fengmei(First People's Hospital of Shangqiu,Shangqiu 476000,China)

机构地区：[1]商丘市第一人民医院,河南商丘476000

出　　处：《中国中西医结合皮肤性病学杂志》2021年第2期158-161,共4页Chinese Journal of Dermatovenereology of Integrated Traditional and Western Medicine

基　　金：河南省科技攻关项目(162102410008)。

摘　　要：目的观察4期人体免疫缺陷病毒(HIV)感染者免疫球蛋白Ig、T淋巴细胞亚群及HIV核糖核酸(RNA)的水平,了解不同时期免疫状态,分析之间的相关性。方法纳入110例HIV感染者,根据世界卫生组织(WHO)HIV临床分Ⅳ期,分别为临床Ⅰ期组、临床Ⅱ期组、临床Ⅲ期组、临床Ⅳ期组,并设无HIV感染者20例为健康对照组。采用免疫比浊法检测血清免疫球蛋白IgA、IgG、IgM;采用流式细胞术检测T淋巴细胞亚群的表达;逆转录聚合酶链反应(RT-PCR)测定各组病毒载量。结果①HIV感染者4组中,IgM、IgA水平测定与健康对照组比较,差异无统计学意义(P>0.05);Ⅱ期组(29.35±2.86)pg/mL、Ⅲ期组(27.64±3.01)pg/mL、Ⅳ期组(28.38±3.42)pg/mL患者IgG水平均高于健康对照组(11.92±2.13)pg/mL,差异有统计学意义(t值分别为9.243、11.338、12.543,P<0.05)。②4组CD4^(+)T细胞计数和CD4^(+)T/CD8^(+)T比值均显著低于健康对照组(P<0.05);4期患者CD8^(+)T计数水平较健康对照组明显升高,二者比较差异有统计学意义(t值分别为9.671、11.325、14.253、12.819,P<0.05)。③4组病毒载量水平:Ⅰ期感染组(2.35±1.09)log10拷贝/mL、Ⅱ期组(4.78±1.64)log10拷贝/mL、Ⅲ期组(5.23±1.45)log10拷贝/mL、Ⅳ期组(6.81±1.72)log10(拷贝/mL。④所有HIV感染者的HIV RNA载量与CD4^(+)T、CD4^(+)T/CD8^(+)T水平呈负相关(R=-0.564、P<0.001,R=-0.209、P=0.028),HIV RNA载量与CD8^(+)T、IgG水平存在一定正相关(R=0.479、P<0.001,R=0.375、P<0.001)。结论不同临床分期HIV感染者的免疫状况差异有统计学意义,通过纵向比较之间变化水平,说明检测血清免疫球蛋白、T淋巴细胞亚群与HIV RNA载量有助于了解病情,可衡量抗病毒疗效和预后。Objective In order to observe the levels of immunoglobulin Ig,T lymphocyte subsets and human immunodeficiency virus Ribonucleic Acid(HIV RNA)in four stages of HIV infection,and to understand the correlation between immune status in different periods and analysis.Methods A total of 110 HIV-infected patients were enrolled.According to the World Health Organization(WHO)HIV clinical stage,including:the I stage group,the second stage group,the third stage group,the fourth stage group,and 20 cases without HIV infection as healthy controls.Serum immunoglobulin IgA,IgG and IgM were detected by immunoturbidimetry.The expression of T lymphocyte subsets was detected by flow cytometry.The HIV viral load of each group was determined by Reverse Transcription-Polymerase Chain Reaction(RT-PCR).Results①In the four groups of HIV-infected patients,IgM and IgA levels were not significantly different from those in the healthy control group(P>0.05);the second-stage group(29.35±2.86)pg/mL,Ⅲgroup(27.64±3.01)pg/mL,Ⅳgroup(28.38±3.42)pg/mL patients with IgG levels higher than healthy control group(11.92±2.13)pg/mL,the difference was statistically significant(t=9.243,11.338,12.543;P<0.05).②CD4^(+)T cell count and CD4^(+)T/CD8^(+)T in the four groups were significantly lower than the healthy control group(P<0.05);the fourth stage CD8^(+)T count was significantly higher than the healthy control group.The difference was statistically significant(t values were 9.671,11.325,14.253,12.819,P<0.05).③Four groups of viral load levels:stageⅠinfection group(2.35±1.09)log10 copies/mL,stageⅡgroup(4.78±1.64)log10 copies/mL,stageⅢgroup(5.23±1.45)log10 copies/mL,ⅣPeriod group(6.81±1.72)log10 copies/mL.④The HIV RNA load of all HIV-infected patients was negatively correlated with CD4^(+)T and CD4^(+)T/CD8^(+)T levels(R=-0.564,P<0.001,R=-0.209,P=0.028),HIV viral load was positively correlated with CD8^(+)T and IgG levels(R=0.479,P<0.001,R=0.375,P<0.001).Conclusion There are significant differences in the immune status of HIV-infecte

关 键 词：免疫球蛋白 淋巴细胞 艾滋病毒 

分 类 号：R521.91[医药卫生—内科学]