人类免疫缺陷病毒感染后不同疾病阶段的胃黏膜病理改变

目的 评价胃黏膜中CD4~+T淋巴细胞群与外周血CD4~+T淋巴细胞及病毒载量的相关性.探讨HIV感染后不同疾病阶段患者的胃黏膜病理改变.方法 选取HIV感染者36例,根据全血CD4~+T淋巴细胞计数和临床症状,将研究对象分为HIV感染无症状者和AIDS患者两组,免疫组织化学方法检测CD4~+T淋巴细胞在胃黏膜中的表达,以直线回归分析、Spearman等级相关分析进行统计.结果 随着疾病的进展,HIV感染者胃黏膜腺体萎缩和间质增生逐渐加重,而黏膜中浸润炎性细胞及淋巴细胞进行性减少,并普遍存在淋巴细胞噬黏膜腺体现象.HIV感染者血清病毒载量与胃黏膜内CD4~+T淋巴细胞呈负线性相关(r=-0.336,P=0.01),全血CD4~+T淋巴细胞与胃黏膜中CD4~+T淋巴细胞呈正相关(r=0.5762,P<0.01).结论 HIV感染后,患者胃黏膜组织出现多种病理改变,并随着病程阶段的进展而加重,胃黏膜中CD4~+T淋巴细胞群与全血CD4~+T淋巴细胞计数和病毒载量的相关性即是这种改变的具体体现.

Pathological changes of gastric mucosa in different stages of human immunodeficiency virus infection

Objective To evaluate the pathological changes of gastric mucosa tissues in different stages of human immunodefieiency virus (HIV) infection and the correlations between CD4~+ T lymphocyte pool of gastric mucosa and CD4~+ T lymphocyte count/HIV load of peripheral blood. Methods Thirty-six HIV-infected individuals were recruited into this investigation, and were divided into two groups, i.e. asymptomatic HIV carriers and acquired immune deficiency syndrome (AIDS) patients, based on CD4~+ T lymphocyte count and clinical symptom. Immunohistochemistry was used to detect expression of CD4~+ T lymphocytes in gastric mucosa. The correlations between mucosal CD4~+ T lymphocyte pool and CD4~+ T lymphocyte count/HIV load of peripheral blood were analyzed by the straight line regression analysis and Spearman rank correlation analysis. Results Along with disease progression, gland atrophy and interstitial hyperplasia in gastric mucosa of HIV-infected individuals became worse, while the number and the proportion of the inflammatory cells infiltrating gastric mucosa gradually decreased. Moreover, the phenomenon that lymphocytes phagocytized mueosal epithelium and gland was common in HIV-infected individuals. Serum HIV load and mucosal CD4~+ T lymphocyte pool had a strong negative linear correlation ( r=-0.336, P=0.01 ), while CD4~+ T lymphocyte count of peripheral blood and mucosal had a strong positive correlation (r=0.5762,P<0.01). Conclusions Several kinds of pathological changes can develop in gastric mucosal tissues of HIV-infected individuals along with the disease stage progression. CD4~+ T lymphocyte count of gastric mucosa is correlated with serum HIV load and CD4~+ T lymphocyte count of peripheral blood in these patients.