不同类型T淋巴细胞在艾滋病病程发展中的临床意义研究  

A Study of the Clinical Significance of Different Typesof T Lymphocytes in the Course of AIDS

作　　者：翟云霞 胥萍[1] 李晋 刘洪艳 宋华峰[1] 陈慧[1] 薛婧[1] 郦芳华 赵静[1] ZHAI Yunxia;XU Ping;LI Jin;LIU Hongyan;SONG Huafeng;CHEN Hui;XUE Jing;LI Fanghua;ZHAO Jing(Inspection Center of Suzhou Fifth People’s Hospital,Suzhou 215131,China)

机构地区：[1]苏州市第五人民医院检验中心,江苏苏州215131

出　　处：《标记免疫分析与临床》2023年第6期960-967,1065,共9页Labeled Immunoassays and Clinical Medicine

基　　金：苏州市科技发展计划项目(编号:SKJYD2021136);国家自然科学基金(编号:81902054);苏州市科技局民生科技(编号:SYS2020190);苏州市生物医药产业创新医工结合协同创新研究项目(编号:SLJ2022022)。

摘　　要：目的通过研究不同类型T淋巴细胞在艾滋病病程发展中的差异,探讨不同类型T淋巴细胞在艾滋病病程中的表达情况及临床意义,为临床早期诊断及调整用药方案提供一定的参考价值。方法采用病例对照的研究方法。对苏州市第五人民医院的艾滋病住院患者进行研究。本研究共选取143例艾滋病患者,将其分为单纯艾滋病组、艾滋病合并真菌感染组、艾滋病合并多重感染组,将这3组作为艾滋病病程发展中的3个阶段进行对照研究。采用GraphPad、SPSS对全部数据进行统计分析。结果本研究中,总共比对研究了9个相关指标,其中CD4^(+)T淋巴细胞、CD8^(+)T淋巴细胞、CD4/CD8、CD64指标在单纯艾滋病组与艾滋病合并真菌感染组之间差异存在统计学意义,联合CD4^(+)T淋巴细胞、CD8^(+)T淋巴细胞、CD4/CD8以及CD64可建立预测模型共同预测艾滋病患者是否合并了真菌感染,联合指标具有较高的诊断效能(0.937),灵敏度(83%)和特异性(96%)。而CD4^(+)T淋巴细胞、CD8^(+)T淋巴细胞、L/CD45在单纯艾滋病组与艾滋病合并真菌感染组之间差异存在统计学意义,联合CD4^(+)T淋巴细胞、CD8^(+)T淋巴细胞、L/CD45构建预测模型能够显著提高对艾滋病合并多重感染的诊断能力,诊断效能(0.929),灵敏度为91%,特异性为90%。艾滋病合并真菌感染组与艾滋病合并多重感染组之间无指标差异存在统计学意义,无法在两组之间进行鉴别。结论分析了各淋巴细胞指标在3组患者间的差异,建立了艾滋病患者疾病进程的预测模型,显著提高艾滋病合并真菌感染患者与艾滋病合并多重感染患者的确诊率,及时调整用药治疗方案,避免患者在接受抗逆转录病毒治疗时因抗真菌药物与抗病毒药物相互作用而对机体造成的伤害,对临床初步诊断与治疗工作有一定参考价值。Objective To investigate the expression and clinical significance of different types of T lymphocytes in the course of AIDS by studying the development of different types of T lymphocytes,so as to provide an useful reference for the early clinical diagnosis and adjustment of drug regimen.Methods This study used a case-control research method.AIDS inpatients from the Fifth People’s Hospital in Suzhou were enrolled.A total of 143 AIDS patients were selected for this study and divided into the AIDS alone group,the AIDS combined with fungal infection group and the AIDS combined with multiple infections group.These three groups reflected three stages in the development of the AIDS disease process for the controlled study.Graphpad and SPSS were used for statistical analysis.Results In this trial,a total of nine relevant indicators were studied comparatively.Among them,CD4^(+)T lymphocytes,CD8^(+)T lymphocytes,CD4/CD8 and CD64 indices were statistically different between the AIDS-only group and the AIDS-combined fungal infection group,and the combination of CD4^(+)T lymphocytes,CD8^(+)T lymphocytes,CD4/CD8 to CD64 could establish a predictive model jointly.The combination of CD4^(+)T-lymphocytes,CD8^(+)T-lymphocytes and CD4/CD8 with CD64 could be used as a predictive model to predict the presence of fungal infections in patients with AIDS,with a high predictive accuracy(0.937),sensitivity(83%)and specificity(96%).The combination of CD4^(+)T-lymphocytes,CD8^(+)T-lymphocytes and L/CD45 was statistically different between the AIDS-only group and the AIDS-combined fungal infection group,and the predictive model of CD4^(+)T-lymphocytes,CD8^(+)T-lymphocytes and L/CD45 significantly improved the diagnosis of AIDS-combined multiple infections,with a predictive accuracy(0.929),sensitivity(91%)and specificity(90%).There was no indicator that was statistically different between the AIDS co-infected fungal group and the AIDS co-infected multiple infections group,so it was not possible to differentiate between these two groups.Con

关 键 词：艾滋病 真菌感染 多重感染 淋巴细胞 

分 类 号：R512.91[医药卫生—内科学]