HIV-1感染者CD4＋T淋巴细胞及其各亚群细胞增殖和消亡情况的观察

目的探讨艾滋病病毒I型（HIV-1）感染者CD4＋T淋巴细胞（CD4细胞）及其各细胞亚群：纯真细胞（TN）、中心记忆细胞（TCM）和效应记忆细胞（TEEM）的增殖和消亡情况。方法观察23例未经抗病毒治疗、感染时间大于12个月的HIV-1感染者，以16例健康者为对照，通过流式细胞仪分析CDtT淋巴细胞CD45RO和CD2，的表达情况，把CD4细胞分为TN（CD45RO—CD27＋）、TM（CD45RO＋CD27＋）和TEM（CD45RO＋CD27-）三个亚群。以Ki-67抗原的表达代表细胞的增殖，AnnexinV检测阳性代表细胞的消亡，比较HIV-1感染组和健康组CD4细胞及其各个亚群增殖和消亡的情况。结果健康组（n-16例）CD4细胞增殖率为（O．36±0．24）％，各亚群增殖率分别为Tw（O．07士0．05）％，TcM（O．57±0．52）％和TEM（O．40±0．39）％；CD4细胞消亡率为（6．30土2．41）％，各亚群消亡率分别为TN（4．43士2．21）％，1rcM（6．58±2．50）％和T巳Ⅵ（12．47--4-8．98）％；与之相比，HIV-1感染组（n=23例）：CD4细胞增殖率为（2．93±2．72）％（z=-4．511，P=0．000），各亚群增殖率：TN（0．524-0．42）％（z=-4．785，P=0．000），TcM（5．55±5．07）％（z=--4．241，P=0．000）和TEM（4．53±5．20）％（z=-3．884，P=0．000）；CD4细胞消亡率为（23．59±16．27）％（z=-3．883，P=0．000），各亚群消亡率：TN（17．25±15．80）％（z=-2．227，P=0．026），TcM（25．16±16．55）％（z=-3．940，P-0．000），TEM（29．56±16．77）％（z=-3．626，P=0．000）。与健康组相比，HIV-1感染组CD4及其各细胞亚群增殖率和消亡率明显增加，差异有统计学意义。结论与健康组相比，HIV-1感染者CD4细胞及其各个亚群细胞消亡和增殖有明显增加，细胞进入高速更新的状态，纯真细胞亚群和记忆细胞亚群组成比没有明显变化。

Investigation on proliferation and death of CD＋ T cell and its subsets in HIV-1 infections

Objective To observe the changes in proliferation and death of CD4＋ T cell （TCD4＋） and its subsets including naive CD＋ cell （TN）, central memory CD4＋ cell （TcM） and effect memory CD% T cell （TEM） in HIV-1 in- fected patients. Methods Sixteen healthy controls and 23 untreated HIV-1 infected patients whose infection dura- tion was over 12 months were enrolled for observation. Flow cytometry tests were carried out after routine staining. CD＋ T cells were divided into three subsets based on CD45 RO and CD27 expressions. They were TN （CD45 ROCD27＋ ）, TCM （CD45 RO＋ CD27＋ ）, and TEM （CD45 RO＋ CD27- ） respectively. Cell proliferation was indicated by Ki-67 antigen expression. Cell death was indicated by positive Annexin V stain. Cell proliferation and death rates were com- pared between the HIV-1 infected group and the healthy control group. Results The CD4＋ T cell proliferation rates in the healthy controls were TcD4＋ 0. 36%±0. 24%, TN0. 07%±0. 05%, TCM0. 57%±0. 52%, and TEM0. 40%± 0. 39% respectively. The death rates in the healthy controls were TCD4 ＋ 6.30%± 2.41%, TN 4. 43 %± 2. 21 %, TCM 6. 58 % ± 2. 50 %, and TEM 12. 47 %± 8. 98 % respectively. The proliferation rates in the HIV-1 infected group were TcD4＋ 2.93%±2.72%（z=-4.511,P=0.000）, TN0. 52% ± 0. 42% （z= - 4. 785, P= 0. 000） , TCM5.55%±5.07%（z=--4. 241,P=0. 000）, TEM4. 53%± 5. 20% （Z=- 3.884, P= 0.000）; the, death rates in this group were TCD4 ＋ 23.59 % ± 16.27 % （z = -- 3. 883, P =0.000）, TN17. 25% ±15. 80% （z= - 2. 227, P= 0.026）, TCM25.16% ± 16.55% （z = -- 3. 940, P= 0. 000）, and TEM29. 56%±16. 77%（z=--3. 626,P= 0. 000）. Compared with the normal controls, the proliferaiion and death rates in the HIV-1 infected group were dramatically increased and the changes had statistic difference. Conclusions Compared with the normal controls, the proliferation and death of CD＋ T cell and its sub- sets in the HIV-1 infected group were dramatically increased. CD＋ T