摘要
目的探讨人类免疫缺陷病毒(HIV)感染合并结核(tuberculosis TB)病对CD4+/CD8+比值的影响。方法选取在重庆市公共卫生医疗救治中心就诊的单纯HIV感染者、单纯结核病患者及HIV合并TB患者各200例分别作为HIV组、TB组、HIV-TB组,分析各组患者CD4+T淋巴细胞和CD4+/CD8+比值的变化。结果三组患者CD4+T淋巴细胞和CD4+/CD8+比值比较差异均有统计学意义(χ2=56.141,232.052;P<0.001),均为TB组最高,HIV-TB组最低。按照CD4+T淋巴细胞计数0~100 cells/μl、101~200 cells/μl、201~350 cells/μl、351~500 cells/μl、>500 cells/μl进行分层,分析三组CD4+/CD8+比值的差异发现,TB组最高,HIV-TB组和HIV组两组间差异无统计学意义(χ0-1002=11.991,P0-100=0.002;χ101-2002=47.656,P101-200<0.001;χ201-3502=76.130,P201-350<0.001;χ351-5002=36.895,P351-500<0.001;χ>5002=40.926,P>500<0.001)。在CD4+T淋巴细胞<500 cells/μl时,HIV-TB组的CD4/CD8比值在CD4任何水平均出现倒置(Z0-100=7.913,P0-100<0.001;Z101-200=4.197,P101-200<0.001;Z201-350=6.948,P201-350<0.001;Z351-500=4.012,P351-500<0.001),在CD4+T淋巴细胞>500 cells/μl时,HIV-TB组的CD4+/CD8+比值在正常范围内。三组CD4+/CD8+比值与CD4+T淋巴细胞变化趋势的差异分析结果提示,以HIV组为参照,随着CD4+T淋巴细胞的下降,CD4+/CD8+比值HIV-TB组比HIV组下降更缓慢,差异有统计学意义(斜率小0.119,P<0.001)。结论三组感染均可导致CD4+T淋巴细胞下降,并随着CD4+T淋巴细胞的下降,HIV-TB合并感染和HIV感染均可出现CD4+/CD8+比值倒置,而TB感染CD4+/CD8+比值无倒置。
OBJECTIVE To explore the impact of human immunodeficiency virus(HIV)infection combined with tuberculosis(TB)on CD4^+/CD8^+ratio.METHODS Totally 200 patients with simple HIV infection,200 patients with simple TB and 200 HIV infection patients complicated with TB who were treated in Chongqing Public Health Medical Treatment Center were enrolled in the study and were assigned as the HIV group,the TB group and the HIV-TB group,respectively.The changes of CD4^+T lymphocyte and CD4^+/CD8^+ratio of the three groups of patients were observed.RESULTS There were significant differences in the CD4+T lymphocyte and CD4+/CD8+ratio among the three groups of patients(χ^2=56.141,232.052;P<0.001),the percentage of CD4^+T lymphocyte and CD4^+/CD8^+ratio were the highest in the TB group and the lowest in the HIV-TB group.The stratified analysis that was performed based on CD4+T lymphocytes counts 0-100 cells/μl,101-200 cells/μl,201-350 cells/μl,351-500 cells/μl and>500 cells/μl showed that the CD4^+/CD8^+ratio was the highest in the TB group,and there was significant difference between the HIV-TB group and the HIV group(χ0-1002=11.991,P0-100=0.002;χ101-2002=47.656,P101-200<0.001;χ^2201-350=76.130,P201-350<0.001;χ351-5002=36.895,P351-500<0.001;χ>5002=40.926,P>500<0.001).When CD4^+T lymphocyte counts were less than 500 cells/ul,the CD4/CD8 ratio of the HIV-TB group was inverted in all layers(Z0-100=7.913,P0-100<0.001;Z101-200=4.197,P101-200<0.001;Z201-350=6.948,P201-350<0.001;Z351-500=4.012,P351-500<0.001);when the CD4^+T lymphocyte counts were more than 500 cells/μl,the CD4+/CD8+ratio of the HIV-TB group was within the normal range.The result of difference analysis of the change trends of CD4+/CD8+ratio and CD4+T lymphocyte indicated that taking the HIV group as a reference,the CD4+/CD8+8 ratio was decreased more slowly in the HIV-TB group than in the HIV group with the decrease of the CD4+T lymphocytes,and there was significant difference(with the slope less than 0.119,P<0.001).CONCLUSION All of the three groups can res
作者
聂静敏
钱娟
何雪姣
黄锐
陈思源
陈耀凯
NIE Jing-min;QIAN Juan;HE Xue-jiao;HUANG Rui;CHEN Si-yuan;CHEN Yao-kai(Chongqing Public Health Medical Center,Chongqing 400036,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2020年第17期2615-2619,共5页
Chinese Journal of Nosocomiology
基金
“十三五”国家科技重大专项基金资助项目(2018ZX10302104)。
