HIV/AIDS患者外周血T淋巴细胞亚群与中医证候的相关性分析

目的 探讨人类免疫缺病毒/艾滋病(HIV/AIDS)患者外周血T淋巴细胞亚群与中医证候的相关性.方法 采用艾滋病中医四诊信息采集表对133例HIV/AIDS患者进行临床调查与12个月的随访,使用人机结合的方法对四诊信息进行辨证分型,并同时监测T淋巴细胞亚群CD4+、CD8+计数,分析T淋巴细胞亚群各项指标与中医证侯的相关性.结果 HIV/AIDS患者入组时出现频率居前4位的中医证型为肝郁气滞、气阴两虚、脾气虚弱、肝胃不和；随访12个月后出现频率居前4位的中医证型为肝郁气滞、气阴两虚、脾气虚弱、脾肾阳虚.其中入组时肝胃不和证患者的CD4+、CD8+计数均高于脾气虚弱证和气阴两虚证患者(P＜0.05或P＜0.01),肝郁气滞证患者CD8+计数高于脾气虚弱证患者(P＜0.01);随访12个月后CD4+、CD8+计数在HIV/AIDS不同证型的患者之间比较差异无统计学意义(P＞0.05).入组时和高效抗逆转录病毒(HAART)治疗12个月后HIV/AIDS不同基本证型患者CD4+T淋巴细胞免疫重建差异均无统计学意义(P＞0.05)；初始CD8+计数分层与HAART治疗12个月后的免疫学应答情况的关联系数r=0.384,具有统计学意义(P＜0.001).结论 AIDS患者外周血T淋巴细胞亚群CD4+、CD8+计数与中医证型密切相关.

Relation between Peripheral Blood T lymphocyte Subsets and Chinese Medicine Syndrome in HIV/AIDS Patients

Objective To analyze the relation between peripheral blood T lymphocyte subsets and Chinese medicine syndrome in human immunodeficiency virus/acquired immune deficiency syndrome(HIV/AIDS) patients.Methods Totally 113 HIV/AIDS patients were investigated and followed up for 12 months.Man-machine system was used to identify the syndromes according to the diagnostic materials.CD4+ counts and CD8+ counts were monitored.The relation between peripheral blood T lymphocyte subsets and Chinese medicine syndrome was analyzed.Results At the beginning,the top four Chinese medicine syndromes were liver depression and qi stagnation syndrome,qi-yin deficiency syndrome,spleen qi deficiency syndrome and liver-stomach disharmony syndrome.After 12 months of follow-up,the top four Chinese medicine syndromes were liver depression and qi stagnation syndrome,qi-yin deficiency syndrome,spleen qi deficiency syndrome and spleen-kidney yang deficiency syndrome.At the beginning,CD4+ and CD8+ counts in liver-stomach disharmony syndrome were significantly higher than those in spleen qi deficiency syndrome and qi-yin deficiency syndrome(P<0.05 or P<0.01),and CD8+ counts in liver depression and qi stagnation syndrome were significantly higher than that in spleen qi deficiency syndrome(P<0.01).After 12 months of follow-up,there was no significant difference between syndromes in CD4+ and CD8+ counts(P>0.05).There was no significant difference in immune reconstitution of CD4+ of all syndromes before and after highly active antiretroviral treatment(P>0.05).There was statistical significance in correlation coefficient of initial CD8+ counts stratification and immunological response 12 months later(r=0.384,P<0.001).Conclusion The CD4+ and CD8+ counts in peripheral blood T lymphocyte subsets are closely related to Chinese medicine syndrome in AIDS patients.