艾滋病合并HIV视网膜病变85例临床分析

目的探讨艾滋病(AIDS)病人艾滋病病毒(HIV)视网膜病变的发病特点及临床表现特征。方法回顾273例有眼底照片的AIDS病人的资料,分析85例有HIV视网膜病变病人的CD4+T淋巴细胞计数、棉絮斑部位及数量、出血部位、眼别等,探讨HIV视网膜病变的发病特点和临床表现。结果273例AIDS病人中,发现有HIV视网膜病变的85例,发病率为31.14%。单、双眼均可发病,主要表现为眼底棉絮斑,大多部分伴有出血,单纯出血和Roth斑较少。大多位于眼底后极部,可自行消退;HIV视网膜病变病人的CD4+T淋巴细胞计数小于200细胞/μl,86%的病人CD4+T淋巴细胞计数低于100细胞/μl,近50%的病人CD4+T淋巴细胞计数低于50细胞/μl;不同CD4+T淋巴细胞水平间患眼棉絮斑数量比较,差异无统计学意义;各水平间棉絮斑、出血构成比比较差异无统计学意义。结论AIDS病人视网膜病变主要表现为棉絮斑,出现在细胞免疫水平较低的病人。随着免疫功能降低而发病率增加。AIDS病人应做常规眼科检查。     

利用混合效应线性模型分析甘肃省HIV/AIDS病人HAART后CD_4~+T淋巴细胞的变化

目的了解甘肃省接受高效抗反转录病毒治疗(HAART)的艾滋病(AIDS)病人CD+4T淋巴细胞(简称CD4细胞)的变化趋势,分析不同性别、年龄、感染途径治疗人群的治疗效果是否存在差异。方法利用SPSS 19.0描述艾滋病病毒(HIV)感染者/AIDS病人(简称HIV/AIDS病人)CD4细胞在治疗后5年内不同时间点上的分布情况,使用混合效应线性模型拟合CD4细胞计数与性别、年龄、感染途径等因素之间的关系。结果选取103例HIV/AIDS病人,男性占67.96%,女性占32.04%;治疗开始年龄以21~50岁为主,占86.41%;感染途径以性接触传播为主,占68.93%。开始治疗前病人CD4细胞中位数为156个/μL,治疗1、2、3、4、5年后,CD4细胞中位数分别为290个/μL、309个/μL、344个/μL、347个/μL、525个/μL。CD4细胞计数与治疗时间和开始治疗时CD4细胞水平正相关;性别和治疗开始年龄没有显著性差异;经男男性行为和血液途径感染的艾滋病病人治疗效果存在统计学差异(P0.05)。结论甘肃省接受HAART治疗的艾滋病病人在5年内CD4细胞计数有上升趋势,男男性行为感染者的治疗效果较经血液感染者好。     

豫西南地区新发现HIV/AIDS病人外周血淋巴细胞亚群及WB带型分析

目的分析豫西南地区新发现的艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)的外周血淋巴细胞亚群和实验室蛋白印迹条带(WB)带型,为平顶山市的艾滋病防控寻找依据。方法选取2014年1月至2016年12月,平顶山市疾病预防控制中心艾滋病确证实验室检测的580例HIV/AIDS病人为研究对象,设置AIDS病人(A组)、HIV感染者(B组)、健康体检者(C组),统计分析三组外周血淋巴细胞亚群[CD4~+T淋巴细胞(简称CD4细胞)、CD8~+T淋巴细胞(简称CD8细胞)、CD4/CD8]计数、比值和WB带型。结果 B组108例HIV感染者,CD4细胞计数、CD4/CD8比值低于137例健康体检者(对照组),CD8细胞计数高于对照组(P0.05);A组472例AIDS病人CD4细胞和CD8细胞计数、CD4/CD8比值低于B组,差异有统计学意义(P0.05)。将A组和B组按照性别(男女)、年龄(50岁,≤50)再分组,按CD4细胞和CD8细胞计数、CD4/CD8比值对比,差异均无统计学意义。A组、B组WB全带型和次全带型发生率对比分析,差异有统计学意义;按照WB全带型和次全带型分析,A、B两组CD4细胞和CD8细胞计数对比,差异均有统计学意义;A组WB全带型与次全带型组内分析,CD4细胞计数、CD4/CD8比值对比,差异均有统计学意义,CD8细胞计数对比,差异无统计学意义;B组全带型与次全带型组内分析,CD4/CD8比值对比,差异有统计学意义。结论豫西南地区新发现病例以艾滋病病人为主,淋巴细胞破坏较重,HIV感染者次全带的发生率显著高于艾滋病病人。     

Panleucogating方法计数CD_4~+T淋巴细胞的研究进展

目的阐述Panleucogating方法计数艾滋病病毒(HIV)感染者/AIDS病人(HIV/AIDS病人)CD+4T淋巴细胞(CO4细胞)的方法、发展和应用。方法收集HIV/AIDS病人CD+4细胞检测方法的文献,分析Panleucogating方法的可行性及其优势和不足。结果发现Panleucogating方法与常规方法检测的CD+4细胞数值之间存在较高的相关性。该方法具有检测成本低、操作简单、检测迅速等优势。结论 Panleucogating方法可用于HIV/AIDS病人CD4细胞计数的检测,在经济欠发达地区有应用价值。     

中西医结合治疗对艾滋病免疫重建不全者CD4~+T淋巴细胞影响

目的分析云南省中西医结合治疗对高效抗反转录病毒治疗(HAART)后免疫重建不全患者CD4~+ T淋巴细胞(简称CD4细胞)的影响。方法收集2005年9月至2016年12月在云南省接受国家中医药治疗,并在入组前已接受HAART满2年的艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)的CD4细胞数据。结果共有781例病人纳入研究,其中免疫重建不全组135例,对照组646例,接受中西医结合治疗后,两组病人CD4细胞计数上升或稳定。治疗后12个月时,免疫重建不全组有效占74.0%,稳定占22.0%,对照组有效占33.9%、稳定占57.4%;治疗24个月时,免疫重建不全组有效占78.0%、稳定占18.1%,对照组有效占39.1%、稳定占51.6%。结论中西医结合治疗可一定程度提高或稳定HIV/AIDS病人CD4细胞计数水平,且对免疫重建不全病人作用更具有优势。     

中药(XQ-9302)治疗HIV感染者/AIDS患者CD4细胞计数和病毒载量变化的评价

目的　探讨中药 (XQ 930 2 )对艾滋病病毒 (HIV)感染者 /艾滋病 (AIDS)患者的治疗作用。方法　测定XQ 930 2治疗 2 1例HIV感染者 /AIDS患者的CD4细胞计数和病毒载量 ,并与仅进行对症治疗的HIV感染者 /AIDS患者对照组比较。结果　经XQ 930 2治疗后 ,4 2 9%HIV感染者 /AIDS患者的CD4细胞计数上升 >5 1% ,为显效 ;33 3%患者的CD4细胞计数升高 11%～ 5 0 % ,为有效 ,总有效率为 76 2 % ;CD4细胞计数上升 <10 %为无效 ,无效率为 2 3 8%。 5 2 4 %HIV感染者 /AIDS患者的病毒载量下降≥ 1log ,呈显效 ;38 1%的HIV感染者 /AIDS患者病毒载量无变化或下降 <1log ,为有效 ;仅 9 5 %HIV感染者 /AIDS患者病毒载量上升 ,为无效。所有HIV感染者 /AIDS患者的临床症状均获改善。对照组HIV感染者 /AIDS患者病毒载量呈稳定及上升状态 ,临床症状均未获改善 ,呈无效。结论　XQ 930 2对HIV感染者 /AIDS患者的CD4细胞计数上升以及病毒载量下降有效 ,且能改善临床症状。     

豫西南地区新发现HIV/AIDS病人外周血淋巴细胞亚群及WB带型分析北大核心CSCD

目的分析豫西南地区新发现的艾滋病病毒（HIV）感染者/艾滋病（AIDS）病人（简称HIV/AIDS病人）的外周血淋巴细胞亚群和实验室蛋白印迹条带（WB）带型,为平顶山市的艾滋病防控寻找依据。方法选取2014年1月至2016年12月,平顶山市疾病预防控制中心艾滋病确证实验室检测的580例HIV/AIDS病人为研究对象,设置AIDS病人（A组）、HIV感染者（B组）、健康体检者（C组）,统计分析三组外周血淋巴细胞亚群[CD4^＋T淋巴细胞（简称CD4细胞）、CD8^＋T淋巴细胞（简称CD8细胞）、CD4/CD8]计数、比值和WB带型。结果 B组108例HIV感染者,CD4细胞计数、CD4/CD8比值低于137例健康体检者（对照组）,CD8细胞计数高于对照组（P〈0.05）;A组472例AIDS病人CD4细胞和CD8细胞计数、CD4/CD8比值低于B组,差异有统计学意义（P〈0.05）。将A组和B组按照性别（男女）、年龄（〉50岁,≤50）再分组,按CD4细胞和CD8细胞计数、CD4/CD8比值对比,差异均无统计学意义。A组、B组WB全带型和次全带型发生率对比分析,差异有统计学意义;按照WB全带型和次全带型分析,A、B两组CD4细胞和CD8细胞计数对比,差异均有统计学意义;A组WB全带型与次全带型组内分析,CD4细胞计数、CD4/CD8比值对比,差异均有统计学意义,CD8细胞计数对比,差异无统计学意义;B组全带型与次全带型组内分析,CD4/CD8比值对比,差异有统计学意义。结论豫西南地区新发现病例以艾滋病病人为主,淋巴细胞破坏较重,HIV感染者次全带的发生率显著高于艾滋病病人。     

HIV感染者/AIDS患者外周血CD38 HLA-DR分子在CD4+ CD8+T淋巴细胞上的表达

目的　观察国内艾滋病病毒 (HIV)感染者 /艾滋病 (AIDS)患者外周血CD38、HLA DR分子在CD+4 、CD+8T淋巴细胞上表达的变化 ,并探讨这些变化的临床意义。方法　用流式细胞仪检测 5 1例正常对照、14例HIV感染者和 3 6例AIDS患者的外周血CD+4 、CD+8T淋巴细胞表面的CD38、HLA DR分子的表达 ,用分枝DNA(bDNA)法检测 11例HIV感染者和 18例AIDS患者的血浆病毒载量。结果　CD+4 HLA DR+细胞百分比显示 ,AIDS组显著高于正常组及HIV组 ;CD+8HLA DR+T细胞百分比显示HIV组与AIDS组间无差异 ,而它们均显著高于正常组。CD+8、CD38+细胞百分比则是AIDS组 >HIV组 >正常组 ,CD+8CD38+、CD+8HLA DR+、CD+4 HLA DR+细胞百分比与病毒载量显著正相关。结论　在HIV感染过程中 ,HLA -DR+、CD38+在CD+4 、CD+8T淋巴细胞上的表达均显著增加 ,反映T淋巴细胞异常激活 ;尤其是CD+8CD38+细胞百分比随着疾病进展逐渐升高 ,预示疾病进展程度。在评价HIV感染者和AIDS患者的免疫状况时 ,不仅要考虑免疫细胞数量和功能的变化 ,还应考虑免疫细胞的激活水平     

云南地区HIV/AIDS患者合并深部真菌感染的类型及免疫学特征分析

目的分析云南地区近5年HIV/AIDS患者合并深部真菌感染的类型与免疫学特征。方法采集住院HIV/AIDS患者送检血液、脑脊液、骨髓、痰及脓液等标本进行菌种的培养及鉴定,用流式细胞技术检测合并深部真菌感染的HIV患者外周血T淋巴细胞亚群。结果 645例合并深部真菌感染的HIV/AIDS中分离出菌株702株,共11种,包括念珠菌304株(占43.3%),马尔尼菲篮状菌231株(占32.91%),新型隐球菌151株(占21.51%)。不同感染类型患者的CD4~+T淋巴细胞水平比较差异有统计学意义(χ~2=77.414,P0.01)。合并马尔尼菲篮状菌和新型隐球菌感染者的CD8~+T淋巴细胞水平比较差异有统计学意义(χ~2=33.624,P0.01)、马尔尼菲篮状菌与念珠菌感染的患者CD8~+T淋巴细胞水平比较差异有统计学意义(χ~2=13.161,P0.01)。HIV/AIDS患者合并感染真菌种类与CD4~+T/CD8~+T水平具有相关关系(χ~2=45.013,P0.01)。结论 HIV/AIDS患者易合并深部真菌感染,且不同菌种感染者的T淋巴细胞亚群构成不同。应根据艾滋病患者CD4~+、CD8~+ T淋巴细胞计数及CD4~+T/CD8~+T比值变化,进行治疗以降低病死率。     

200例HIV/AIDS病人心电图改变与CD4~+T淋巴细胞计数的关系

目的分析艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)心电图改变与CD4~+T淋巴细胞(简称CD4细胞)计数的关系,以及HIV/AIDS病人心电图有无特征性改变。方法根据CD4细胞计数结果分级(I级:500个/μL;Ⅱ级200个/μL至≤500个/μL;Ⅲ级≤200个/μL),比较三组HIV/AIDS病人心电图异常率的差异和各组心电图特征性改变的差异。结果心电图异常率,CD4细胞计数I级为25.0%,Ⅱ级60.5%,Ⅲ级76.7%,三组之间差异有统计学意义(χ~2=16.51,P0.01)。心电图的特征性改变按频率从高到低依次为快心律失常、ST-T改变、左房室肥大、慢心律失常、低电压、右房室肥大。不同CD4细胞计数组别的异常心电图比较,快心律失常的差异有统计学意义(χ~2=7.01,P0.05)。结论 HIV/AIDS病人心电图异常率、快心律失常均与CD4细胞计数分级有关。     

乙型肝炎患者外周血T淋巴细胞亚群的检测

乙型病毒性肝炎(乙肝)的肝细胞损害和炎症反应是免疫细胞作用于肝细胞的结果,以T淋巴细胞破坏已感染乙型肝炎病毒(HBV)的肝细胞的作用最为重要.我们对乙肝患者外周血T淋巴细胞亚群和e抗原系统之间的关系进行了探讨.     

Effects of Long-time Exposure to Lipopolysaccharide on Intestinal Lymph Node Immune Cells and Antibodies Level in Mice

Background: Endotoxin, widely present in the living environment of humans and animals, leads to endotoxemia during a short period. However, the long-term effects of endotoxin on immune function are unclear. Objective: To determine the importance of long-term endotoxin treatment on function of immune system. Methods: The mice were treated with different doses of lipopolysaccharide (LPS) for a month; the collected samples were then analyzed in terms of value changes in hematological parameters, lymphocyte subtypes, and immunoglobulins level. Results: The number of monocytes (MONO) and neutrophils (NEU) in the three treatment groups was significantly lower than the control after 30 days. However, the proportion of CD8+ T lymphocytes showed a rising trend in the mesenteric lymph nodes (MLNs) and Peyer's patches (PPs) while the CD4+ T cell was reduced. At the same time, a decrease was observed in the percentage of CD19+CD38+ B lymphocytes. Interestingly, the change of lymphocytes in PPs was more significant than that in MLNs, suggesting that immune response in the PPs occurred before the MLNs. Consistent with the changes in B cells, the content of IgA and IgG showed a downward trend. Conclusion: Long-term exposure to low-dose endotoxin had little or no effect on the immune function of the body, suggesting that the endotoxin can be rapidly eliminated by the immune system. Nonetheless, the number of immune cells was reduced in the high-dose group. T- and B-lymphocytes were significantly reduced, resulting in a decrease in immunoglobulin level, and showing a significant immune suppression state.     

风湿性心脏病细胞免疫及调控失衡初探

目的 :探讨风湿性心脏病 (RHD)细胞免疫是否存在异常及其特点 ,为 RHD的早期免疫诊断及今后的免疫疗法提供依据。方法 :对 41例 RHD和 44例 RHD伴风湿活动 (RF)患者的 T淋巴细胞亚群、淋巴细胞转化率、自然杀伤 (NK)细胞数量及活性 ,HL A- DR抗原遗传位点进行了测定 ,并与正常对照组 (5 0例 )比较。结果 :RHD和 RF组细胞免疫功能活性增强 ,表现为 CD4数量增加 ,CD8数量减少 ,CD4/ CD8比值增大 ,与正常对照组比较 P <0 .0 5和 P <0 .0 1;RF组淋巴细胞转化率较正常对照组和 RHD组高 (P <0 .0 1) ,NK细胞数量增加 ,但活性降低 (P <0 .0 1和 P <0 .0 5 ) ;RF和 RHD组 HL A- DR4抗原呈高频分布 (5 3.6 %和 47.7% ) ,DR5 呈低频分布(14.6 %和 15 .9% ) (P <0 .0 1)。结论 :RHD存在细胞免疫功能异常 ,且发生自身免疫趋式 ,其机制可能是细胞免疫调控失衡。 DR4的高频分布 ,可作为 RHD早期诊断的危险度估计     

Alcoholic Hepatitis as a T-Cell Mediated Disorder: An Hypothesis

BACKGROUND: The mechanism by which alcohol induces alcoholic hepatitis, the precursor lesion for cirrhosis, has never been elucidated. In particular, direct toxicity has not been proven. This article reviews the hypothesis that a primary target of chronic alcohol ingestion is the T lymphocyte. The lesion in the T lymphocyte is characterized by reduced baseline secretion of cytokines, including tumor necrosis factor-alpha; although characterized by an exaggerated release of cytokines when stimulated by polyclonal activators such as endotoxin. High concentrations of cytokines, especially tumor necrosis factor-alpha, within the liver induce necrosis/apoptosis of hepatocytes. METHODS: Data supporting this hypothesis in rodent models are reviewed. CONCLUSION: A strategic approach for testing this concept in man is defined.     

再生障碍性贫血患者细胞免疫功能与白细胞介素8水平检测

目的：探讨再生障碍性贫血（再障）的免疫发病机制,阐明Ｔ细胞亚群及ＩＬ－８ 在再障患者中的变化及临床意义。方法：用单抗试剂盒,采用ＳＡＰ法和双抗夹心酶联免疫吸附法（ＥＬＩＳＡ）对９ 例再障患者和１０ 例正常人外周血Ｔ 细胞亚群及血清ＩＬ－８ 含量进行测定。结果：再障患者外周血ＣＤ３、ＣＤ４ 亚群细胞减低,ＣＤ８ 亚群细胞增高,ＣＤ４／ＣＤ８ 降低,再障患者血清中ＩＬ－８ 含量明显高于正常对照组。结论：细胞免疫功能异常及造血负调控因子ＩＬ－８ 可能在再障发病中起一定的作用。     

中医阴黄本质探讨

目的:从现代医学角度研究阴黄的机理。方法:观察黄疸患者的症状与体征,分析T淋巴细胞亚群转化率,检测胆酸(CG)、透明质酸(HA)、层粘蛋白(LN)等指标。结果:阳黄湿热证病毒复制活跃,体液免疫功能亢进,肝细胞炎症反应明显,血清总胆红素、谷丙转氨酶显著上升,表现出正邪抗争剧烈的态势;而阴黄证谷丙转氨酶轻度增高或不增高,胆红素残留不退,病毒复制减弱,外周血细胞数降低,血清C_3处于低水平,T淋巴细胞CD_8接近正常,血清LN、HA显著上升。表明阴黄患者肝细胞损伤坏死反应趋于减弱或停止,有向肝纤维化方向发展的趋势。结论:阴黄是肝细胞处理胆红素能力不足、肝脏纤维化、肝脏微循环障碍等多种因素造成的复合证候。     

The dominant human conjunctival epithelial CD8αβ+ T cell population is maintained with age but the number of CD4+ T cells increases

The conjunctiva is a highly specialized ocular mucosal surface that, like other mucosa, houses a number of leukocyte populations. These leukocytes have been implicated in age-related inflammatory diseases such as dry-eye, but their phenotypic characteristics remain largely undetermined. Existing literature provides rudimentary data from predominantly immunohistochemical analyses of tissue sections, prohibiting detailed and longitudinal examination of these cells in health and disease. Using recovered cells from ocular surface impression cytology and flow cytometry, we examined the frequency of leukocyte subsets in human conjunctival epithelium and how this alters with age. Of the total CD45+ leukocyte population within the conjunctival epithelium, 87% [32–99] (median) [range] comprised lymphocytes, with 69% [47–90] identified as CD3 + CD56- T cells. In contrast to peripheral blood, the dominant conjunctival epithelial population was TCRαβ + CD8αβ + (80% [37–100]) with only 10% [0-56%] CD4+ cells. Whilst a significant increase in the CD4+ population was seen with age (r = 0.5; p < 0.01) the CD8+ population remained unchanged, resulting in an increase in the CD4:CD8 ratio (r = 0.5;p < 0.01). IFNγ expression was detectable in 18% [14–48] of conjunctival CD4+ T cells and this was significantly higher among older individuals (<35 years, 7[4–39] vs. >65 years, 43[20–145]; p < 0.05). The elevation of CD4+ cells highlights a potentially important age-related alteration in the conjunctival intra-epithelial leukocyte population, which may account for the vulnerability of the aging ocular surface to disease.     

The Beneficial Effects of Lymphocytapheresis for Treatment of Nephrotic Syndrome

Abstract: A considerable permeability factor (or factors) derived from circulating T cells has a crucial role in proteinuria of nephrotic syndrome (NS). We attempted to remove pathogenic T cells through lymphocytapheresis (LCAP) in 6 patients with primary NS, 2 patients with minimal change nephrotic syndrome (MCNS), 2 patients with focal segmental glomerulosclerosis (FSGS), 1 patient with membranous nephropathy (MN), and 1 patient with MN and FSGS using Cellsorba (Asahi Medical Co., Osaka, Japan). LCAP was performed 2 times in 2 consecutive weeks and was followed with corticosteroid therapy with or without cyclosporine A in 5 patients. Two patients with MCNS, 1 with FSGS, and 1 with MN and FSGS showed a dramatic decrease of proteinuria (?30% and ?94%) in their urine protein/creatinine ratio. Three out of 4 patients had a complete or partial remission (proteinuria <1g/day) within 8 weeks following immunosuppressive therapy. During the LCAP, T cells, especially activated T cells, decreased significantly in the response group. The other 2 patients, 1 with FSGS and 1 with MN, however, had no response to LCAP and following immunosuppressive therapy or low‐density lipoprotein apheresis and suffered from end‐stage renal failure or death by pneumonia. These results suggested that LCAP might have a beneficial effect on the treatment of NS, especially MCNS and in some patients with FSGS, despite varying responses to LCAP and concomitant immunosuppressive therapy.     

T细胞与慢性阻塞性肺疾病

目前慢性阻塞性肺疾病（COPD）的发生机制尚未完全明确,普遍认为它是一种慢性气道炎症,中性粒细胞、嗜酸粒细胞、肺泡巨噬细胞和淋巴细胞似乎都参与了炎症过程,然而,哪种细胞在此发生机制中发挥主要作用仍不清楚。近年来T细胞及其亚群在COPD发病机制中的作用日益受到重视。     

Murine Model of Ethanol-Induced Immunosuppression

Alcohol abuse has been associated with an increased susceptibility to infectious diseases and certain tumors. On the basis of these observations, an effect of ethanol on the immune system has been suggested. We have used a mouse model system in which male C57Bl/6 mice were fed either Lieber-DeCarli liquid diet containing ethanol sufficient to supply 37% of the total calories or isocaloric control diet in a pair-feeding design to examine the effect of ethanol on the immune system. The group consuming the ethanol-containing diet maintained relatively stable levels of blood ethanol for the 8 days of feeding. Consumption of ethanol for 8 days resulted in a profound loss of thymus and spleen cells, and the recovery of thymus cellularity was delayed relative to the recovery of spleen cell numbers after ethanol feeding was discontinued. Proliferation of spleen lymphocytes to T-cell stimuli (concanavalin A and alloantigens) was diminished; however, B-cell proliferation to lipopolysaccharide was relatively unchanged in mice fed ethanol-containing diet. Also in ethanol-fed mice a significant decrease in the primary antibody response to sheep red blood cells but not to the T-independent antigen trinitrophenol-ficoll occurred. These data establish the murine model system as a means to define further the effect of ethanol on the immune system and host defense mechanisms.