低蛋白血症对HIV阳性肺结核患者T细胞亚群及临床特征的影响  

Effects of hypoproteinemia on T cell subsets and clinical features in HIV-positive patients with pulmonary tuberculosis

作　　者：刘士甫[1] 赵磊[1] 佘丽君 王立静[1] 戴二黑[1] 刘洪德[1] 王海宾[1] LIU Shifu;ZHAO Lei;SHE Lijun;WANG Lijing;DAI Erhei;LIU Hongde;WANG Haibin(The Fifth Hospital of Shijiazhuang,Hebei 050000,China)

机构地区：[1]石家庄市第五医院,河北050000

出　　处：《医学动物防制》2023年第4期325-328,共4页Journal of Medical Pest Control

基　　金：河北省科技成果重点推广计划(20220204)。

摘　　要：目的分析低蛋白血症对HIV阳性肺结核患者的T细胞亚群、临床表现、影像学特征及治疗反应的影响。方法比较病例组32例HIV阳性肺结核合并低蛋白血症患者与对照组32例HIV阳性肺结核白蛋白正常患者的T淋巴细胞亚群、临床特征、影像学特点、抗结核治疗6个月病灶吸收程度和不良反应发生情况。结果病例组T淋巴细胞CD3+(Z=3.28,P<0.05)、CD4+(Z=3.27,P<0.05)T细胞计数明显低于对照组;病例组发热(χ^(2)=11.13,P<0.05)、咳嗽(χ^(2)=4.95,P<0.05)、疲劳气促(χ^(2)=5.11,P<0.05)、体重下降(χ^(2)=5.08,P<0.05)比率明显高于对照组;病例组胸部CT出现胸腔积液和(或)心包积液(χ^(2)=9.04,P<0.05)、多叶病变(χ^(2)=4.27,P<0.05)的比率明显高于对照组;抗结核治疗6个月病例组胸部CT病灶显著吸收(χ^(2)=9.41,P<0.05)比率明显低于对照组;治疗过程病例组发生消化道反应(χ^(2)=9.97,P<0.05)、药物性肝损伤(χ^(2)=7.73,P<0.05)及其他药物不良反应(χ^(2)=25.00,P<0.05)比率明显高于对照组。结论低蛋白血症可能导致HIV阳性肺结核患者的免疫力降低、临床症状加重,影响病灶吸收,导致抗结核治疗过程不良反应增多,不利于病情控制。Objective To analyze the effect of hypoproteinemia on T cell subsets,clinical features,imaging characteristics and treatment response in patients with HIV-positive pulmonary tuberculosis.Methods T lymphocyte subsets,clinical features,imaging characteristics,the degree of lesion absorption and the occurrence of adverse reactions after 6 months of anti-tuberculosis treatment were compared between 32 HIV-positive tuberculosis patients with hypoproteinemia in the case group and 32 HIV-positive tuberculosis patients with normal albumin level in the control group.Results The T lymphocyte CD3+(Z=3.28,P<0.05)and CD4+(Z=3.27,P<0.05)cell counts in the case group were significantly lower than those in the control group.The rates of fever(χ^(2)=11.13,P<0.05),cough(χ^(2)=4.95,P<0.05),fatigue shortness of breath(χ^(2)=5.11,P<0.05)and weight loss(χ^(2)=5.08,P<0.05)in the case group were significantly higher than those in the control group.The rate of pleural effusion and/or pericardial effusion(χ^(2)=9.04,P<0.05)and multilobed lesions(χ^(2)=4.27,P<0.05)in chest CT pulmonary lesions in the case group was significantly higher than that in the control group.The rate of significant absorption of chest CT lesions in the 6-month-old antituberculosis group(χ^(2)=9.41,P<0.05)was significantly lower than that in the control group.During the treatment,the incidence of digestive tract reaction(χ^(2)=9.97,P<0.05),drug-induced liver injury(χ^(2)=7.73,P<0.05)and other adverse drug reactions(χ^(2)=25.00,P<0.05)in the case group were significantly higher than those in the control group.Conclusion Hypoproteinemia may reduce the immunity of HIV-positive pulmonary tuberculosis patients,aggravate the clinical symptoms,affect the absorption of lesions,and increase the adverse reactions during treatment,which is not conducive to the control of the disease.

关 键 词：低蛋白血症 HIV阳性肺结核 T细胞亚群 临床特征 相关性 分析 

分 类 号：R521[医药卫生—内科学]