慢性HIV/HCV合并感染患者血小板指标的变化  

Hepatitis C Virus Co-Infection Aggravate the Reduction of Platelet Counts in Patients with Chronic HIV Infection and Reduce the Reduction of Mean Platelet Volume

作　　者：李韦杰 李蒙蒙 沈从乐 韩佳琪 李亚楠 李辉 王雅杰 LI Weijie;LI Mengmeng;SHEN Congle;HAN Jiaqi;LI Yanan;LI Hui;WANG Yajie(Department of Clinical Laboratory,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Gastroenterology Ward I,Qingdao Hospital of Traditional Chinese Medicine(Qingdao Hiserhospital),Qingdao 266033,China;ICU,First Affiliated Hospital of Tsinghua University,Beijing 100016,China;Infectious Disease Emergency Department,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)

机构地区：[1]首都医科大学附属北京地坛医院检验科,北京100015 [2]青岛市中医医院(青岛市海慈医院)消化一科,山东青岛266033 [3]清华大学第一附属医院ICU,北京100016 [4]首都医科大学附属北京地坛医院感染病急疹科,北京100015

出　　处：《标记免疫分析与临床》2021年第10期1693-1697,1726,共6页Labeled Immunoassays and Clinical Medicine

基　　金：吴阶平医学基金会临床科研专项资助基金(HIV-1 DNA检测临床应用价值探讨)(编号:320.6750.2020-08-35)。

摘　　要：目的探索反映血小板活化和功能的两个重要指标(血小板计数和血小板平均体积)在HCV/HIV合并感染者中的变化及临床意义。方法2016年1月至2020年7月在我院就诊者共502例入组,其中HCV感染者166例,HCV/HIV合并感染者73例,HIV感染者133例及健康体检者130例。收集其临床资料,分析比较其外周血血常规,淋巴细胞分型和肝功能检查结果。结果HIV、HCV及HCV/HIV合并感染者的血小板计数低于健康者(P=0.001),HCV/HIV合并感染者的血小板计数(PLT)高于HCV单感染者、低于HIV单感染者;合并感染者血小板平均体积(MPV)低于HCV单感染者、高于HIV单感染者(P值均=0.002),HIV感染者MPV低于健康者(P<0.001)。PLT与MPV在总样本(r=-0.460,P<0.001)、HCV感染者(r=-0.325,P<0.001)、HCV/HIV合并感染者(r=-0.611,P<0.001)、HIV感染者(r=-0.333,P<0.001)及健康者(r=-0.326,P<0.001)中均呈负相关。结论HCV合并感染可加重慢性HIV感染者PLT的下降、减轻其引起的MPV降低,PLT与MPV负相关,PLT在反映HIV/HCV合并感染者血小板状态方面优于MPV。Objective Both HIV and HCV mono-infection could cause the abnormalities of platelet.This study aimed to explores the changes and clinical significance of platelet counts and mean platelet volume(two important indicators of platelet activation and function)in HCV/HIV co-infection patients.Methods A total of 502 patients were enrolled in this study,including 166 patients with HCV infection,73 patients with HCV/HIV co-infection,133 patients with HIV infection and 130 healthy individuals.The changes of PLT,MPV,Lymphocyte and liver function of the peripheral blood in these patients were analyzed by ANOVA method,Mann-Whitney U-tests and Spearman’s rank-correlation accordingly.Results Platelet counts levels of HIV,HCV and HCV/HIV co-infection patients were lower than those of healthy people(HCV,HCV/HIV co-infection patients vs healthy person,P<0.001;HIV-infected patients vs healthy person,P=0.001).The platelet counts of HCV/HIV co-infected patients were higher than those of HCV-infected patients,while lower than those of HIV-infected.MPV of patients with co-infection was lower than that of HCV-infected patients,while higher than that of HIV-infected patients(all P=0.002).Conclusion HCV co-infection can aggravate the decrease of PLT and alleviate the decline of MPV score in chronic HIV infection.Platelet counts is negatively correlated with MPV score.PLT but not MPV shows a strong applicability in reflecting status of platelet patients with HIV/HCV co-infection.

关 键 词：丙型肝炎病毒 艾滋病 肝功能 淋巴细胞 血小板 

分 类 号：R512.63[医药卫生—内科学] R512.91[医药卫生—临床医学]