摘要
目的探讨机会性感染病原体对新发艾滋病患者高效抗逆转录病毒治疗过程中外周血T淋巴细胞亚群分布的影响。方法收集2019年1月1日至2020年6月30日昆明市第三人民医院感染一科收治的初次确诊且未经抗病毒治疗的艾滋病患者220例,经临床诊断,220例中艾滋病合并结核分枝杆菌33例,艾滋病合并丙型肝炎病毒30例,艾滋病合并马尔尼菲篮状菌31例,其余病例中艾滋病合并1种病原体45例,艾滋病合并2种病原体30例,艾滋病合并3种及以上病原体51例,治疗方案为富马酸替诺福韦二吡呋酯片+拉米夫定+依非韦伦(TDF+3TC+EFV),分别于治疗前、治疗3、6、12个月采集患者抗凝血样本,采用流式细胞术检测患者外周血T淋巴细胞亚群,对比分析各组患者抗病毒治疗过程中外周血T淋巴细胞亚群分布情况。结果艾滋病合并结核分枝杆菌(AIDS/TB)、艾滋病合并丙型肝炎病毒(AIDS/HCV)、艾滋病合并马尔尼菲篮状菌(AIDS/TM)3组患者在治疗3个月后CD3^(+)、CD8^(+)和CD4^(+)T淋巴细胞计数都明显升高,差异有统计学意义(P<0.05),除了AIDS/TM组治疗6个月后CD4^(+)T淋巴细胞计数再次明显升高,其余2组3项指标随后治疗过程中无明显变化,差异无统计学意义(P>0.05);治疗1a后3组患者的CD3^(+)和CD8^(+)T淋巴细胞计数无明显差异,差异无统计学意义(P>0.05);而AIDS/HCV组CD4^(+)T淋巴细胞计数要高于其它2个组,差异有统计学意义(P<0.05)。艾滋病合并1种病原体(AIDS/1)组抗病毒治疗3个月后CD3^(+)和CD8^(+)T淋巴细胞计数明显升高,差异有统计学意义(P<0.05),整个治疗过程中CD4^(+)T淋巴细胞计数无明显变化,差异无统计学意义(P>0.05);艾滋病合并2种病原体(AIDS/2)组治疗6个月后CD3^(+)及治疗3个月后CD8^(+)T淋巴细胞计数明显升高,差异有统计学意义(P<0.05);艾滋病合并3种及以上病原体(AIDS/≥3)组治疗6个月后,CD3^(+)和CD8^(+)T淋巴细胞计数才明显升高;AIDS/2�
Objective To investigate the influence of opportunistic infectious pathogens on the distribution of peripheral blood T lymphocyte subsets in newly acquired AIDS patients during efficient antiretroviral therapy.Methods A total of 220 AIDS patients who were first diagnosed and not performed with antiviral treatment in Infectious Disease Department I of Kunming Third People's Hospital from January 1,2019 to June 30,2020 were collected.According to clinical diagnosis,out of 220 patients,33 patients had AIDS combined with mycobacterium tuberculosis,30 patients had AIDS combined with hepatitis C virus,31 patients had AIDS with Talaromyces marneffei,45 patients had AIDS combined with 1 pathogens,30 patients had AIDS with 2 pathogens,and 51 patients had AIDS with 3 or more pathogens.The treatment regimen was Tenofovir disoproxil fumarate tablets+lamivudine+EFV(TDF+3TC+EFV).Anticoagulant samples were collected before treatment,3,6 and 12 months after treatment.The peripheral blood T lymphocyte subsets were detected by flow cytometry.The distribution of peripheral blood T lymphocyte subsets in each group during antiviral treatment was compared and analyzed.Results The counts of CD3^(+),CD8^(+)and CD4^(+)T lymphocyte in 3 groups of patients including the patients with AIDS combined with mycobacterium tuberculosis(AIDS/TB),the patients with AIDS combined with hepatitis c virus(AIDS/HCV)and the patients with AIDS combined with Talaromyces marneffei(AIDS/TM)were significantly increased after 3 months treatment,and the differences were of statistical significance(P<0.05).As for AIDS/TM group,the CD4^(+)T lymphocyte count increased significantly after 6 months of treatment;As for the other two groups,there was no obvious change of 3 indexes in the subsequent treatment,and the difference was statistically significant.(P>0.05).There was no significant difference in the count of CD3^(+)and CD8^(+)T lymphocytes in the three groups after 1 year of treatment,and the difference was of no statistical significance(P>0.05);The CD4^(+)T ly
作者
黄山
吕松琴
段洪芬
施金丽
李光敏
黄岗
李佳能
李晓非
HUANG Shan;LV Song-qin;DUAN Hong-fen;SHI Jin-li;LI Guang-min;HUANG Gang;LI Jia-neng;LI Xiao-fei(The Third People’s Hospital of Kunming/Clinical Centre for Infectious Diseases in Yunnan Province,Kunming Yunnan 650041,China)
出处
《昆明医科大学学报》
CAS
2021年第11期159-165,共7页
Journal of Kunming Medical University
基金
云南省地方本科高校基础研究联合专项基金资助项目(2018FH001-091)。
关键词
艾滋病
机会性感染
T淋巴细胞亚群
高效抗逆转录病毒治疗
Acquired immune deficiency syndrome
Opportunistic infection
T lymphocyte subset specificity
Highly active antiretroviral therapy
