HIV／AIDS患者CD4＋T淋巴细胞数的变化与外周血淋巴细胞总数的变量的关系研究

目的研究人免疫缺陷病毒（HIV）感染者和艾滋病（AIDS）患者CIM＋T淋巴细胞数的变化（△CD4＋T）和外周血淋巴细胞总数的变量（△TLC）的相关性，探讨用△TLC预测CD4＋T在监测HIV疾病进展和高效抗逆转录病毒治疗（HAART）疗效中发挥的作用。方法分析91例HIV／AIDS患者CD4＋T和TLC及△CD4＋T和△TLC的相关性，通过ROC面积、敏感度、特异度、阳性预测值和阴性预测值分析，寻找能有效预测CD4＋T淋巴细胞数〈200个／μl，〈350个／μl，时TLC的范围；△CD4＋T淋巴细胞数为50个／μl、100个／μl、200个／μl、300个／μl时△TLC的范围。结果91例HIV／AIDS患者CD4＋T和TLC相关系数r为0．716，P〈0．01；△TLC和△CD4＋T具有更强的相关性，相关系数r为0．809，P〈0．01。用1300个／μl和1700个／μl TLC预测CD4＋T200个／μl和350个／μl具有显著的预测价值。用△TLC 170个／μl、330个／μl、630个／μl、910个／μl分别预测△CD4＋T50个／μl、100个／μl、200个／μl、300个／μl，各项预测指标基本上在90％以上，显著高于相同时间下TLC预测CD4＋T的效果。结论人免疫缺陷病毒（HIV）感染者和艾滋病（AIDS）患者CD4＋T淋巴细胞数的变化（△CD4＋T）和外周血淋巴细胞总数的变量（△TLC）具有直线相关性。在条件匮乏的艾滋病高发区，可以应用△TLC预测△CD4＋T．比TLC更加直观、准确的反映HIV感染者疾病进展和评价AIDS患者HAART的疗效。

Study on the correlation between the change of CD4 + T cell counts and the variance of total lymphocyte counts in HIV/AIDS patients

Objective To analyze the correlation between the change of CD4 + T lymphocyte count (△CD4 +T) and the variance of peripheral blood total lymphocyte count(△TLC) and evaluate the effect of △TLC to substitute for CD4 +T count to predict HIV progression monitoring and the curative effect on clinical HAART treatment in HIV/AIDS patients. Methods Study the correlation between TLC and CD4 + T count and the correlation between △TLC and △CD4 + T count in 91 patients with HIV/AIDS. Study the date of ROC are-a, sensitivity, specificity, positive predictive value and negative predictive value for CD4 + T 200/μl, 350/μl to find the extent of TLC. Study the date of ROC area, sensitivity, specificity, positive predictive value and negative predictive value for △CD4 +T 50/μl、100/μl、200/μl、300/μl to find the extent of △TLC. Results The sig-nificant correlation (r value) between TLC and CD4 + T count was 0.716(P<0.01) in the patients. The re-markable dynamical correlations between△TLC and △CD4 + T were found comparing to that between TLC and CD4 + T count r value was 0.809(P<0.01). It was significant value in prediction CD4 + T count 200/μl and 350/μl with TLC cut-off 1300/μl and 1700/μl. Moreover,as more significant market to predict optimal △CD4 +T for 50/μl,100/μl,200/μl,for300/μl, △TLC were 170/μl,330/μl,630/μl,910/μl respectively. Conclu-sion There is straight line correlation between the change of CD4 + T cell counts and the variance of total lym-phocyte counts in HIV/AIDS patients. TLC especially △TLC for prediction of △CD4 + T can be available as a substitute method to estimate HIV disease progression and clinical HAART in some resource-constrained area of China.