摘要
目的了解接受高效抗逆转录病毒治疗(HAART)人类免疫缺陷病毒(HIV)感染患者和获得性免疫缺陷综合征(AIDS)患者的CD4+T淋巴细胞动力学特点,并探讨其影响因素。方法描述CD4+T淋巴细胞在HAART治疗后3年内不同时间的变化规律,利用广义估计方程分析不同性别、年龄、民族、职业、传播途径、WHO临床分期和基线CD4+T淋巴细胞水平等因素对CD4+T淋巴细胞动力学变化的影响。结果基线(治疗前2周)、3、6、9、12、15、18、21、24、27、30、33和36个月的中位数CD4+T淋巴细胞分别为96、194、217、212、250、268、282、289、305、311、331、338和357个/μl;与基线比较,各随访时间的中位数CD4+T淋巴细胞增加值分别为80、99、101、124、146、166、178、194、190、234、237和236个/μl。性别、WHO临床分期和基线CD4+T淋巴细胞水平3个因素的组间CD4+T淋巴细胞动力学影响比较,差异有统计学意义(χ2=9.718、25.361和22.230,P<0.05);年龄、民族、职业和传播途径4个因素的组间CD4+T淋巴细胞动力学影响比较(χ2=0.032、0.433、0.119和0.101,P>0.05),差异无统计学意义;性别、年龄、民族、职业、传播途径、WHO临床分期和基线CD4+T淋巴细胞水平7个因素的不同检测时间CD4+T淋巴细胞动力学影响比较,差异有统计学意义(χ2=397.781、384.920、370.505、383.165、385.180、392.199和389.468,P<0.05)。结论 HIV/AIDS患者在接受HAART治疗3年内,随着抗病毒治疗(ART)时间延长,其CD4+T淋巴细胞呈进行性上升趋势,其动力学变化可分为3个阶段:1快速增长阶段,治疗后1~6个月,每个月增长近20个/μl;2缓慢增长阶段,治疗后6~24个月,平均每月增长近10个/μl;3平台期,治疗24个月后,增长速度逐步下降,至第30个月时CD4+T淋巴细胞不再增加。性别、WHO临床分期和基线CD4+T淋巴细胞水平是影响CD4+T淋巴细胞动力学改变的3个因素。
[Objective] To understand CD4^＋ T lymphocyte dynamic characteristics and its influence factors for HIV-infected and AIDS patient （HIV/AIDS） after highly active antiretroviral therapy （HAART）. [Methods] The CD4^＋ T lymphocyte dynamic characteristics were observed by descriptive research method during the 3 years after HAART. The factors influencing the dynamics of CD4^＋ T lymphocytes, which included gender, age, nationality, occupation, route of transmission, WHO clinical stage and baseline CD4^＋ T lymphocyte level, were analyzed by generalized estimating equations in different groups. [Results] The median CD4^＋ T lymphocytes of the baseline, 3th, 6th, 9th, 12th, 15th, 18th, 21st, 24th, 27th, 30th, 33rd and 36th month were 96, 194, 217, 212, 250, 268, 282, 289, 305, 311, 331, 338 and 357 /μl, respectively. Compared to the baseline level, the added value of the CD4^＋ T lymphocytes at the follow-up time points were 80, 99, 101, 124, 146, 166, 178, 194, 190, 234, 237 and 236/μl, respectively. There were significantly differences in the gender, WHO clinical stage and baseline CD4^＋T lymphocyte level between the groups （χ^2= 9.718, 25.361 and 22.230, P〈 0.05）. There were no significantly differences in the age, nationality, occupation or the route of transmission between the groups （χ^2=0.032, 0.433, 0.119 and 0.101, P〉0.05）. There were significantly differences in repeated measurement time of gender, age, nationality, occupation, route of transmission, the WHO clinical stage and baseline CD4^＋T lymphocyte level （χ^2= 397.781, 384.920, 370.505, 383.165, 385.180, 392.199 and 389. 468, P〈 0.05）. [ Conclusions ] In HIV/AIDS patients, CD4^＋T lymphocytes show a rising trend with the extension of antiviral treatment time （ART） during the 3 years after HAART. Its dynamic characteristics can be divided into three stages： the first stage （1st-6th month after ART） is the rapid growth stage in which CD4^＋T lymphocytes increase nearly 20 μl each month; the second stage
出处
《中国现代医学杂志》
CAS
北大核心
2015年第20期58-62,共5页
China Journal of Modern Medicine
基金
广西自然科学基金(No:2013GXNSFAA019213)
广西柳州市科学研究与技术开发计划课题(No:2013J030401)
广西卫生厅计划课题(No:Z2013645)
