HIV/AIDS 患者骨髓抑制与CD4+T细胞计数及HIV病毒载量相关性分析

目的 了解HIV/AIDS患者骨髓抑制与CD4⁺T细胞计数及病毒载量的关系。方法 入组53例北京佑安医院2015年1月—2017年12月收治住院的HIV/AIDS患者,观察外周血象特征、骨髓造血情况、CD4⁺T淋巴细胞计数及HIV病毒载量情况,比较不同骨髓抑制程度与CD4⁺T细胞计数、病毒载量的差异。结果 按CD4⁺T细胞计数,将53例患者分为CD4⁺T细胞>200个/μL组和CD4⁺T细胞≤200个/μL组,CD4⁺T细胞>200个/μL组16例,CD4⁺T细胞≤200个/μL组37例。CD4⁺T细胞≤200个/μL组患者外周血中红细胞计数、白细胞计数、淋巴细胞计数均明显低于CD4⁺T细胞>200个/μL组,差异有统计学意义（P<0.05）。CD4⁺T细胞≤200个/μL组中,三系减少8例,两系减少12例,一系减少9例;但在CD4⁺T细胞>200个/μL组,三系减少1例,两系减少2例,一系减少5例,两组比较差异有统计学意义（P<0.05）。按骨髓分级分0、I~Ⅱ、Ⅲ~Ⅳ级三组,HIV病毒载量中位数分别为1.60 、4.08、4.67 Log（copies/mL）,三组比较差异有统计学意义（P<0.05）。三组的CD4⁺T细胞分别为156、131、28个/μL,三组比较差异有统计学意义（P<0.05）。结论 HIV/AIDS 患者病毒载量越高,骨髓抑制现象越明显,导致血细胞减少为主的外周血血象异常。

Correlation analysis between myelosuppression and CD+T cell counts and HIV viral load in HIV/AIDS patients

Objective To study the relationship between myelosuppression and CD4⁺T cell count and HIV virus load in HIV/AIDS patients. Methods A total of 53 cases of HIV/AIDS patients were enrolled in this study from January 2015 to December 2017 in Beijing You′an Hospital, Capital Medical University. The characteristics of peripheral hemogram, bone marrow hematopoiesis, CD4⁺T lymphocyte count and HIV virus load were observed, and the difference of CD4⁺T lymphocyte count and viral load in the groups with different myelosuppression level were compared. Results According to CD4⁺T cell count, 53 patients were divided into CD4⁺T cells >200 /μL group (16 cases) and CD4⁺T cell less than 200 /μL group (37 cases). The number of erythrocytes, leukocytesand lymphocytes count in the peripheral blood of patients with CD4⁺T cells less than 200 /μL were significantly lower than that of >200/μL group in CD4⁺T cells (P<0.05). In the group of CD4⁺T cells less than 200 /μL and >200 /μL group, the cases of reduction of the ternary systems, two lines and one line were 8 cases vs 1 cases, 12 cases vs 2 cases, 9 cases vs 5 cases, respectively (all, P<0.05). In the three groups of myelosuppression grade 0, I-Ⅱ, Ⅲ-Ⅳ, the load of HIV virus medium was 1.60, 4.08, 4.67 Log(copies/mL), respectively. There were significant differences in the three groups (P<0.05). The CD4⁺T lymphocytes medium in the three groups was 156, 131, 28 /μL, respectively, and the difference between the three groups was significant (P<0.05). Conclusion The higher the viral load of HIV/AIDS patients, the more obvious the myelosuppression, which leads to the abnormal peripheral blood hemogrammostly in blood cell reduction.