T淋巴细胞激活亚群在HIV感染中的变化及其临床意义

目的：研究HIV／AIDS患者T淋巴细胞激活亚群的变化，探讨其临床意义。方法：用流式细胞仪检测59例HIV／AIDS患者和51例健康献血员的T淋巴细胞，对其中40例患者的所有健康献血员进一步分析T淋巴细胞激活亚群（HLA－DR^ CD4^ 、HLA-DR^ CD8^ 和CD38^ CD8^ ）；用bDNA病毒定量检测仪检测59例HIV／AIDS患者的血浆HIV病毒载量。结果：与正常人组相比，HIV组和AIDS组的T淋巴细胞各激活亚群的百分比均显著升高，所有激活亚群均与T4细胞计数成反比，而与病毒载量成正比。其中，CD38^ CD8^ 亚群的百分比与T4细胞计数和病毒载量的相关性最为密切，相关系数分别为r=-0.603和r=0.523，（P＜0．01）。结论；HIV／AIDS患者的T淋巴细胞发生持续和异常的免疫激活，细胞激活程度与疾病进展高度相关，测定这些激活的T细胞亚群变化不仅有助于评价HIV／AIDS患者的免疫状况、判断病毒复制的活跃程度，而且对预示疾病进展和临床疗效评价方面均具有重要价值。

Study on the changes of the activated T-lymphocyte subsets and their clinical significance in a group of Chinese HIV/AIDS patients

Objective To study the changes of the activated T-lymphocyte subsets and their clinical significance in a group of Chinese HIV/AIDS patients. Methods T lymphocyte subsets were detected by flow cytometry for 59 Chinese HIV/AIDS patients and 51 healthy blood donors (as a normal group). Furthermore, activated T-lymphocyte subsets including HLA-DR +CD4 +, HLA-DR +CD8 + and CD38 +CD8 + were analyzed in 40 among those patients and all of the healthy blood donors. Plasma HIV viral loads of all the patients were detected by b-DNA System 340. Results Compared with the normal group, all of the activated T-lymphocyte subsets in HIV and AIDS group was significantly increased. The percentages of these activated T-lymphocyte subsets in HIV/AIDS patients were significantly negatively correlated with CD4 count and positively correlated with plasma HIV viral load. Among these activated T-lymphocyte subsets, the CD38 +CD8 + subset was the most strongly correlated with CD4 count and viral load, the coefficients (r) were -0.603 and 0.523 (P<0.01), respectively. Conclusions The cellular activation level is closely correlated with disease progression during HIV infection. To understand the activated T-lymphocyte subsets in HIV/AIDS patients may not only help to evaluate the patients' cellular immune status and the HIV replication, but also be of great values in predicting the progression of the disease and clinical outcome as well.