347例HIV/AIDS患者外周血免疫细胞表达水平的临床意义

目的 分析HIV/AIDS患者外周血免疫细胞的表达水平随CD4+淋巴细胞数量、白蛋白含量、HIV-RNA载量以及合并感染的变化情况,探讨其检测的临床意义。方法 回顾性分析347例HIV/AIDS患者外周血的临床资料,对CD4+、CD8+、B淋巴细胞、自然杀伤细胞(NK)的绝对数、白蛋白(ALB)含量、HIV-RNA载量以及梅毒螺旋体抗体(TP)、乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV)抗体的检测结果进行统计学分析。结果 CD4+含量降低组的HIV/AIDS患者CD8+、B、NK细胞的表达水平低于正常组患者(P<0.01),CD8+、NK、B细胞的含量与CD4+数量呈正相关(P<0.05);白蛋白含量降低组的HIV/AIDS患者CD4+、CD8+、B、NK细胞的表达水平低于正常组的患者(P<0.01),白蛋白含量与CD4+、CD8+、B、NK细胞的数量呈正相关(P<0.01);HIV-RNA阳性患者CD4+、CD8+、B、NK细胞的表达水平低于阴性患者(P<0.01),合并感染率为27.9%,高于阴性患者22.5%(P<0.05),HIV-RNA载量与CD4+、B淋巴细胞含量呈负相关(P<0.05)。结论 CD8+、B、NK细胞的表达水平以及合并感染率与疾病的进展密切相关,对于新发现的HIV/AIDS患者,同时检测血清中TP/HBV/HCV抗体,能准确地掌握合并感染情况,有利于实施个体化治疗方案。

Expression level and clinical significance of immune cells in peripheral blood of 347 HIV/AIDS patients

Objective To analyze the expression levels of immune cells in peripheral blood changed with the number of CD4+ lymphocytes, albumin content, HIV-RNA load and co-infection of the HIV/AIDS patients, and explore the clinical significance of their detections. Methods Based on the retrospective analysis of the data of peripheral blood of 347 HIV/AIDS patients, the detection results of the absolute numbers of peripheral blood CD4+, CD8+, B lymphocytes, natural killer cells (NK), albumin (ALB) content, HIV-RNA load, and presence of Treponema pallidum (TP) antibody, hepatitis B virus (HBV) antibody, and hepatitis C virus (HCV) antibody were statistically analyzed. Results The expression levels of CD8+, B lymphocytes, and NK cells in the HIV/AIDS patients with reduced CD4+ levels were lower than those in the normal group (P<0.01), and the contents of CD8+, NK, and B cells were positively correlated with CD4+ numbers (P<0.05). The expression levels of CD4+,CD8+, B lymphocytes and NK cells in HIV/AIDS patients of the reduced albumin group were lower than those in the normal group (P<0.01), and the numbers of CD4+,CD8+,B and NK cells were positively correlated with the albumin content (P<0.01). The expression levels of CD4+,CD8+, B lymphocytes, and NK cells in the HIV-RNA positive patients were lower than those in the HIV-RNA negative patients (P<0.01), and the combined infection rate in the HIV-RNA positive patients was 27.9%, which was higher than 22.5% in the HIV-RNA negative patients (P<0.05). The HIV-RNA load was negative correlated with CD4+ and B lymphocyte contents (P<0.05), while it had no correlation with the contents of CD8+ and NK cells (P>0.05). Conclusion The expression levels of CD8+, B lymphocytes, NK cells, and co-infection rate are closely related to the disease progression. For the newly discovered HIV-infected patients, the simultaneous detection of TP\HBV\HCV antibodies in the serum can help us accurately grasp the patient's combined infection, which is conducive to the implementation of personalized treatment programs.