梅毒合并人类免疫缺陷病毒感染患者皮肤免疫功能变化的临床分析  

Clinical analysts of skin immune function changes in syphilis patients with human immunodeficiency virus coinfection

作　　者：赵娜 翟霞 刘晴 ZHAO Na;ZHAI Xia;LIU Qing(Dermatology of Traditional Chinese Medicine,Hebei Institute of Dermatology,Baoding 071000,Hebei,China)

机构地区：[1]河北省皮肤病防治院中医皮肤科,河北保定071000

出　　处：《中国性科学》2024年第9期129-132,共4页Chinese Journal of Human Sexuality

基　　金：河北省卫生健康委医学科学研究课题计划(20211751)。

摘　　要：目的分析梅毒合并人类免疫缺陷病毒(HIV)感染患者皮肤免疫功能的变化。方法选取2021年1月至2022年12月河北省皮肤病防治院收治的101例梅毒患者作为研究对象,根据是否合并HIV感染分为HIV阳性组(n=66)和HIV阴性组(n=35)。比较两组患者的基线资料、皮肤组织表皮层指标、免疫功能指标等。结果两组的性别、年龄、血红蛋白(Hb)水平比较,差异无统计学意义(P>0.05)。两组传播途径、婚姻状况有显著差异,且HIV阳性组C反应蛋白(CRP)水平低于HIV阴性组(P<0.05)。在皮肤组织表皮层方面,HIV阳性组的感觉神经末梢密度显著高于HIV阴性组,β-内啡肽和强啡肽A水平显著低于HIV阴性组(P<0.05)。在免疫功能指标方面,HIV阳性组CD4^(+)细胞计数、CD4^(+)/CD8^(+)比值、CD3^(+)细胞计数均低于HIV阴性组,CD8^(+)细胞计数高于HIV阴性组(P<0.05);HIV阳性组辅助性T细胞(Th)1、Th1/Th2比值低于HIV阴性组,Th2高于HIV阴性组(P<0.05);HIV阳性组白介素(IL)-2水平低于HIV阴性组,IL-10水平高于HIV阴性组(P<0.05)。结论梅毒合并HIV感染患者的皮肤免疫功能发生显著变化,表现为感觉神经末梢密度增加、β-内啡肽和强啡肽A水平降低,以及免疫功能指标异常。此外,外周血Th1、Th2、Th1/Th2比值,以及血清IL-2、IL-10水平也存在显著差异。提示HIV感染可能对梅毒患者的免疫系统产生影响。Objective To analyze the changes of skin immune function in syphilis patients with human immunodeficiency virus(HIV)infection.Methods A total of 101 syphilis patients admitted to Hebei Institute of Dermatology from January 2021 to December 2022 were selected as the study objects and divided into HIV-positive group(n=66)and HIV-negative group(n=35)according to whether they were co-infected with HIV.The baseline data,skin tissue epidermal layer index,immune function index and so on were compared between the two groups.Results There were no significant differences in gender,age and hemoglobin(Hb)level between the two groups(P>0.05).There were significant differences in transmission route and marital status between the two groups,and the level of C-reactive protein(CRP)in HIV-positive group was lower than that in HIV-negative group(P<0.05).In the epidermal layer of skin tissue,the density of sensory nerve endings in the HIV-positive group was significantly higher than that in the HIV-negative group,and the levels ofβ-endorphin and dynorphin A were significantly lower than those in the HIV-negative group(P<0.05).In terms of immune function indexes,CD4^(+)cell count,CD4^(+)/CD8^(+)ratio and CD3^(+)cell count in HIV-positive group were lower than those in HIV-negative group,and CD8^(+)cell count was higher than that in HIV-negative group(P<0.05).The helper T cell(Th)1 and Th1/Th2 ratio in HIV-positive group were lower than those in HIV-negative group,and the Th2 ratio was higher than that in the HIV-negative group(P<0.05).The level of interleukin-2(IL-2)in HIV-positive group was lower than that in the HIV-negative group,and the IL-10 level was higher than that in the HIV-negative group(P<0.05).Conclusions The skin immune function of syphilis patients with HIV infection showed significant changes,showing increased density of sensory nerve endings,decreased levels ofβ-endorphin and dynorphin A,and abnormal indicators of immune function.In addition,there were significant differences in Th1,Th2,Th1/Th2 ratios in periphera

关 键 词：梅毒 人类免疫缺陷病毒 皮肤免疫功能 感觉神经末梢密度 免疫功能指标 

分 类 号：R759[医药卫生—皮肤病学与性病学]