HIV/AIDS合并机会性感染患者IP-10、SAA、hs-CRP、PCT、CD4^(+) T细胞计数检测的意义  

Roles of IP-10,SAA,hs-CRP,PCT and CD4^(+)T cell count determinations in HIV/AIDS patients with opportunistic infection

作　　者：赵静 李永勤 李艳 范伟光 杨学刚 ZHAO Jing;LI Yongqin;LI Yan;FAN Weiguang;YANG Xuegang(Department of Infection Laboratory,the People's Hospital of Baoding,Baoding 071000,Hebei,China;Department of Clinical,the People's Hospital of Baoding,Baoding 071000,Hebei,China)

机构地区：[1]保定市人民医院感染科,河北保定071000 [2]保定市人民医院检验科,河北保定071000

出　　处：《检验医学》2023年第8期725-729,共5页Laboratory Medicine

基　　金：保定市科技计划项目(2041ZF150)。

摘　　要：目的探讨人类免疫缺陷病毒(HIV)感染和获得性免疫缺陷综合征(AIDS)(简称HIV/AIDS)合并机会性感染(OI)患者血浆γ-干扰素诱导蛋白10(IP-10)、血清淀粉样蛋白A(SAA)、降钙素原(PCT)、高敏C反应蛋白(hs-CRP)的变化和临床意义。方法选取HIV/AIDS患者187例,根据是否合并OI分为OI组(63例)、无OI组(124例),根据预后情况将合并OI的患者分为预后良好组(45例)和预后不良组(18例)。检测所有患者治疗前和治疗4周后的IP-10、SAA、hs-CRP、PCT水平和CD4+T细胞计数。采用Logistic回归分析评估HIV/AIDS患者合并OI的危险因素。采用Spearman秩相关分析各项指标之间的相关性。结果治疗前预后良好组和预后不良组SAA、PCT、hs-CRP和IP-10水平均显著高于无OI组(P<0.05),预后不良组治疗前IP-10水平高于预后良好组(P<0.05)。预后良好组和无OI组治疗4周后SAA、PCT、hs-CRP和IP-10水平均低于治疗前(P<0.05),而预后不良组治疗前后各项指标差异均无统计学意义(P>0.05)。多因素Logistic回归分析结果显+示,CD4 T细胞计数减少和SAA、PCT、hs-CRP和IP-10升高是HIV/AIDS患者合并OI的危险因素[比值比(OR)值分别为0.028、15.606、25.499、9.147、10.303,95%可信区间(CI)分别为0.006~0.128、3.224~75.532、1.544~421.002、1.705~49.071、2.582~41.118,P<0.05]。Spearman秩相关分析结果显示,IP-10、SAA、hs-+CRP、PCT与CD4^(+)T细胞计数均呈负相关(r值分别为-0.297、-0.390、-0.348、-0.264,P<0.05)。结论CD4^(+)T细胞计数、SAA、PCT、hs-CRP和IP-10与HIV/AIDS合并OI有关,或可作为预后判断的指标。Objective To investigate the changes and clinical roles of plasma interferon-gamma induced protein 10(IP-10),serum amyloid A(SAA),procalcitonin(PCT)and high-sensitivity C-reactive protein(hs-CRP)in patients with human immunodeficiency virus(HIV)infection and acquired immunodeficiency syndrome(AIDS)(referred to as HIV/AIDS)complicated with opportunistic infection(OI).Methods A total of 187 HIV/AIDS patients were enrolled and classified into OI group(63 cases)and non-OI group(124 cases)according to whether they were combined with OI.According to prognosis,the patients with OI were classified into good prognosis group+(45 cases)and poor prognosis group(18 cases).The levels of IP-10,SAA,hs-CRP and PCT and CD4^(+)T cell count were determined in all the patients before and after 4 weeks of treatment.Logistic regression analysis was used to analyze the risk factors of HIV/AIDS patients with OI.Spearman rank correlation was used to analyze the correlation between the indicators.Results Before treatment,the levels of SAA,PCT,hs-CRP and IP-10 in good prognosis group and poor prognosis group were higher than those in non-OI group(P<0.05),and the level of IP-10 in poor prognosis group was higher than that in good prognosis group(P<0.05).After 4 weeks of treatment,the levels of SAA,PCT,hs-CRP and IP-10 in good prognosis group and non-OI group were lower than those before treatment(P<0.05),while there was no statistical significance before and after treatment in poor prognosis group(P>0.05).+Multivariate Logistic regression analysis showed that the decrease of CD4^(+)T cell count and the increase of SAA,PCT,hs-CRP and IP-10 were risk factors for OI in HIV/AIDS patients[odds ratios(OR)were 0.028,15.606,25.499,9.147 and 10.303,95%confidence intervals(CI)were 0.006-0.128,3.224-75.532,1.544-421.002,1.705-49.071 and 2.582-41.118,P<0.05].Spearman rank correlation analysis showed that IP-10,SAA,hs-CRP+and PCT were negatively correlated with CD4^(+)T cell count(r=-0.297,-0.390,-0.348 and-0.264,P<0.05).+Conclusions CD4^(+)T cell count,

关 键 词：γ-干扰素诱导蛋白10 急性时相反应蛋白 人类免疫缺陷病毒 获得性免疫缺陷综合征 机会性感染 

分 类 号：R446.1[医药卫生—诊断学]