不同CD4+基线值艾滋病患者高效抗逆转录病毒治疗后免疫重建效果观察

目的 了解高效抗逆转录病毒疗法（highly active antiretroviral therapy,HAART）治疗艾滋病（acquired immune deficiency syndrome,AIDS）患者时,不同CD4⁺基线值艾滋病患者经过治疗后免疫重建效果的差异,为艾滋病患者临床治疗措施的改进提供理论依据。方法 2016 年1月—2017年3月期间,随机选取符合研究要求的艾滋病患者174例,根据CD4⁺T淋巴细胞基线值的不同分为两组,低值组（CD4⁺T淋巴细胞<200/mm³）和高值组（CD4⁺T淋巴细胞≥200/mm³）,每组均为87例患者,比较两组患者治疗前后（1个月、3个月、6个月、12个月）外周血T淋巴细胞各项指标（包括Treg、Th2、Th17、CD4⁺T、CD8⁺T）检测结果的统计学差异。结果 两组患者基本情况和治疗方式构成的差异均无统计学意义（P>0.05）;两组患者治疗3个月（Th17、CD4⁺T、Th17/Treg、CD4⁺T/CD8⁺T） 、治疗6个月（Treg、Th17、CD4⁺T、CD8⁺T、Th2/Treg、Th17/Treg、CD4⁺T/CD8⁺T）、治疗12个月（Treg、Th2、Th17、CD4⁺T、CD8⁺T、Th2/Treg、Th17/Treg、CD4⁺T/CD8⁺T）指标的差异具有统计学意义（P<0.05）;三组患者不同时点指标（Treg、Th2、Th17、CD4⁺T、CD8⁺T、Th2/Treg、Th17/Treg、CD4⁺T/CD8⁺T）的差异具有统计学意义（P<0.05）;两组患者T淋巴细胞具体检测结果差异有统计学意义（P<0.05）。结论 CD4⁺T淋巴细胞基线值低患者,经高效抗病毒治疗后免疫重建效果较差,因此艾滋病患者进行高效抗病毒治疗应尽早进行。

Effect of immune reconstruction after high-efficiency anti-retroviral therapy on AIDS patients with different CD4 + baseline values

Objective Understanding of HAART therapy for HIV/AIDS patients, with different CD4 ⁺ baseline values in immune reconstruction effect after treatment, to provide theoretical basis for the improvement of clinical treatment for patients with HIV/AIDS. Methods In January 2016 - March 2017, 174 patients with AIDS meeting the requirements of the study were randomly selected, depending on the baseline CD4 ⁺ T lymphocytes was divided into two groups, the low group （CD4⁺ T cells < 200 /mm³） and high value group （CD4 ⁺ T≥200/mm³）, 87 patients in each group, compared two groups of patients before and after treatment （1 month, 3 months, 6 months, 12 months） of peripheral blood T lymphocyte indicators （including Treg, Th2, Th17, CD4 ⁺ T and CD8 ⁺ T） test results statistically. Results There was no statistically significant difference with basic situation and treatment between the two groups of patients （P<0.05）. Two groups of patients treatment for 3 months （Th17, CD4 + T, of Th17 / Treg, CD4 ⁺ / CD8⁺ T）, treatment for 6 months （Treg and Th17, CD4 ⁺ T and CD8 ⁺ T, Th2 / Treg and Th17 / Treg and CD4 ⁺ / CD8 + T）, treatment for 12 months （Treg, Th2, Th17, CD4 ⁺ T and CD8 ⁺ T, Th2 / Treg and Th17 / Treg and CD4⁺ / CD8⁺ T） index differences statistically significant （P <0.05）; The differences between the three groups of patients （Treg, Th2, Th17, CD4⁺T, CD8⁺T, Th2/Treg, Th17/Treg, and CD4⁺T/CD8⁺T） were statistically significant （P<0.05）. The results of T lymphocyte detection in the two groups were statistically significant （P<0.05）. Conclusions CD4⁺T lymphocyte baseline value is low, and the effect of immune reconstruction after effective antiviral treatment is poor, so effective antiviral treatment should be carried out as early as possible.