艾滋病病毒感染者淋巴细胞总数和CD4阳性T淋巴细胞数相关性的研究  

Study on the correlation between total and CD4 lymphocyte counts in patients infected with human immunodeficiency virus

作　　者：刘静[1] 张旻[1] 张子宁[1] 韩晓旭[1] 王亚男[1] 姜拥军[1] 尚红[1] 

机构地区：[1]中国医科大学附属第一医院检验科,沈阳110001

出　　处：《中华检验医学杂志》2004年第3期156-158,共3页Chinese Journal of Laboratory Medicine

基　　金：国家"十五"科技攻关课题资助项目 ( 2 0 0 1BA70 5B0 1)

摘　　要：目的　探讨淋巴细胞总数 (TLC)与CD4阳性 (CD4 +)T淋巴细胞数的相关性 ,以及TLC在监测艾滋病病毒 (HIV)感染者疾病进展和高效抗逆转录病毒治疗 (HAART)疗效中的作用。方法　采用Spearman秩和相关回顾性分析我国 75例HIV感染者TLC和CD4 +T淋巴细胞数相关性。根据灵敏度、特异度 ,阳性预测值和阴性预测值 ,估计预测CD4 <2 0 0 /mm3和CD4 <35 0 /mm3 的TLC的临界值。结果　我国HIV感染者的TLC和CD4 +T淋巴细胞数显著相关 (r =0 6 6 4 ,P <0 0 0 1 )。定期随访HIV感染者TLC的变化值 (△TLC)和CD4 +T淋巴细胞数的变化值 (△CD4 )相关(r =0 4 33,P <0 0 0 1 )。 1 3例接受HAART治疗的HIV感染者的TLC和CD4 +T淋巴细胞数相关(r =0 5 33,P <0 0 0 1 )。治疗后△TLC和△CD4相关 (r =0 5 2 1 ,P <0 0 0 1 )。用TLC <1 5 0 0 /mm3预测CD4 <2 0 0 /mm3 灵敏度为 78% ,特异度为 85 % ,阳性预测值为 6 6 % ,阴性预测值为 91 % ;用TLC<1 80 0 /mm3 预测CD4 <35 0 /mm3 灵敏度为 72 % ,特异度为 75 % ,阳性预测值为 79% ,阴性预测值为6 6 %。结论　在条件有限的地区 ,可以用TLC来预测CD4 +T淋巴细胞数 ,监测HIV感染者疾病的进展 。Objective To study the correlation of total lymphocyte count (TLC) to CD4+ T lymphocyte count and evaluate the usefulness of TLC for monitoring disease progression and curative effect of highly active antiretroviral therapy in HIV infected patients Methods Spearman rank correlation between TLC and CD4 count was assessed in 75 HIV infected patients The positive predictive value(PPV), Negative predictive value (NPV), sensitivity and specificity of various TLC cutoffs were computed for CD4<200 cells/mm 3 and CD4<350/mm 3 Results Significant correlation was noted between TLC and CD4 count ( r =0 664, P <0 001) and between the changes of TLC(△TLC) and CD4 cou(△CD4)(r=0.433, P <0.001) in HIV infected patients during follow up survey In addition, the correlation is significant between TLC and CD4 count ( r =0 533, P <0 001) and between the changes of TLC(△TLC)and CD4 count (△CD4)( r =0 521, P <0 001) in HIV infected patients receiving HAART during follow up survey TLC<1 500/mm 3 had a 78% sensitivity,85% specificity,66% PPV and 91% NPV for CD4<200/mm 3 TLC<1 800/mm 3 had a 72% sensitivity, 75% specificity, 79% PPV and 66% NPV for CD4<350/mm 3?Conclusion TLC may be used to predict the CD4+T lymphocyte count and monitor the disease progression and evaluate the curative effect of highly active antiretroviral therapy in HIV infected patients in resource limited settings

关 键 词：艾滋病 淋巴细胞 CD4阳性T淋巴细胞 相关性 获得性免疫缺陷综合征 

分 类 号：R512.91[医药卫生—内科学]