不同免疫状态下HIV合并神经梅毒患者脑脊液CXCL13浓度的变化分析  

Change analysis of B lymphocytes chemokine ligand 13 concentration in the cerebrospinal fluid of patients with human immunodeficiency virus infection combined neurosyphilis under different immune status

作　　者：胡荣欣 郭朋乐 何瑞英 何凯茵 李英[1] 卢斯汉 杜健群 李水凤 陈丽娟 汤琳 HU Rongxin;GUO Pengle;HE Ruiying;HE Kaiyin;LI Ying;LU Sihan;DU Jianqun;LI Shuifeng;CHEN Lijuan;TANG Lin(Department of Dermatology&STD,Guangzhou Eighth People′s Hospital,Guangzhou Medical University,Guangzhou 510440,Guangdong,China;Infectious disease center,Guangzhou Eighth People′s Hospital,Guangzhou Medical University,Guangzhou 510440,Guangdong,China;Infectious Diseases Institute,Guangzhou Eighth People′s Hospital,Guangzhou Medical University,Guangzhou 510440,Guangdong,China)

机构地区：[1]广州医科大学附属市八医院皮肤性病科,广州510440 [2]广州医科大学附属市八医院感染病中心,广州510440 [3]广州医科大学附属市八医院传染病研究所,广州510440

出　　处：《中国性科学》2025年第2期127-131,共5页Chinese Journal of Human Sexuality

基　　金：广东省医学科学技术研究基金项目(A2020482)。

摘　　要：目的探讨不同免疫状态下人类免疫缺陷病毒(HIV)合并神经梅毒(NS)患者脑脊液B淋巴细胞趋化因子配体13(CXCL13)浓度的变化及临床意义。方法选取2020年6月至2022年12月广州医科大学附属市八医院皮肤性病科和感染病中心收治的53例HIV感染合并梅毒住院患者,未合并NS患者(syph+)28例、合并NS患者25例[其中无症状NS(ANS)患者15例、有症状NS(SNS)患者10例]。依据是否合并NS和CD4^(+)T淋巴细胞数量分成:A组(HIV+/NS+,CD4^(+)T淋巴细胞>350 cells/μL,n=13)、B组(HIV+/NS+,CD4^(+)T淋巴细胞≤350 cells/μL,n=12)、C组(HIV+/syph+,CD4^(+)T淋巴细胞>350 cells/μL,n=13)和D组(HIV+/syph+,CD4^(+)T淋巴细胞≤350 cells/μL,n=15)。比较上述组间相关指标和脑脊液CXCL13浓度,并分析不同患者脑脊液中CXCL13浓度和抗凝全血中CD4^(+)T淋巴细胞数量的相关性。结果A组脑脊液CXCL13浓度显著高于C组,B组脑脊液CXCL13浓度高于D组(P<0.05);A和B组、C和D组脑脊液CXCL13的浓度比较,差异无统计学意义(P>0.05)。HIV+/NS+患者脑脊液中CXCL13浓度和抗凝全血中CD4^(+)T淋巴细胞数量无显著相关性(P>0.05)。HIV+/SNS患者脑脊液CXCL13浓度显著高于HIV+/ANS患者(P<0.05),二者免疫状态比较差异无统计学意义(P>0.05)。结论HIV+/NS+患者脑脊液CXCL13浓度显著升高,且这种变化不受免疫状态影响,可为临床诊断HIV合并NS尤其是ANS早期筛查提供依据。Objective To explore the change of B lymphocytes chemokine ligand 13(CXCL13)concentration in the cerebrospinal fluid(CSF)of patients with human immunodeficiency virus(HIV)infection combined neurosyphilis(NS)under different immune status and its clinical significance.Methods A total of 53 inpatients with HIV combined syphilis admitted to the Department of Dermatology&STD,Guangzhou Eighth People′s Hospital,Guangzhou Medical University from June 2020 to December 2022 were selected,including 28 cases not combined with NS(syph+)and 25 cases combined with NS[Among them,there were 15 cases of asymptomatic NS(ANS)and 10 cases of symptomatic NS(SNS)].According to whether NS were combined and the CD4^(+)T lymphocytes count,they were divided into Group A(HIV+/NS+,CD4^(+)T lymphocytes>350 cells/μL,n=13),group B(HIV+/NS+,CD4^(+)T lymphocytes≤350 cells/μL,n=12),group C(HIV+/syph+,CD4^(+)T lymphocytes>350 cells/μL,n=13)and group D(HIV+/syph+,CD4^(+)T lymphocytes≤350 cells/μL,n=15).The related data and concentration of CXCL13 in CSF were compared between the above groups.The correlation between the CXCL13 concentration in CSF and the CD4^(+)T lymphocyte count in anticoagulant whole blood of the patients were analyzed.Results Compared with group C,the concentration of CXCL13 in the CSF of group A was significantly higher.The concentration of CXCL13 in the CSF of group B was significantly higher compared with that in group D(P<0.05).There was no statistically significant difference in the concentration of CXCL13 in the CSF between groups A and B,and between groups C and D.There was no statistically significant correlation between the concentration of CXCL13 in CSF and the number of CD4^(+)T lymphocytes in anticoagulant whole blood in HIV+/NS+patients(P>0.05).The concentration of CXCL13 in the CSF of HIV+/SNS patients was significantly higher than that of HIV+/ANS patients(P<0.05),and there was no statistically significant difference in the immune status between the two groups(P>0.05).Conclusions The concentration of CXCL

关 键 词：人类免疫缺陷病毒 神经梅毒 免疫状态 CD4^(+)T淋巴细胞 脑脊液 B淋巴细胞趋化因子配体13 

分 类 号：R759[医药卫生—皮肤病学与性病学]