摘要
目的探讨人类免疫缺陷病毒/结核病(human immunideficiency virus/tuberculosis,HIV/TB)并发感染患者的外周血T淋巴细胞亚群的表达及其与HIV RNA载量的相关性。方法选取2018年6月~2020年6月在南京市公共卫生医疗中心就诊的HIV/TB并发感染患者38例作为HIV/TB组,另选取单纯人类免疫缺陷病毒/获得性免疫缺陷综合征(human immunodeficiency virus/acquired immune deficiency syndrome,HIV/AIDS)39例作为HIV组,单纯TB患者35例作为TB组,体检健康者35例作为健康对照组。流式细胞术检测各组CD3^(+),CD4^(+),CD8^(+)T细胞计数和CD4^(+)/CD8^(+)比值;荧光定量PCR检测HIV RNA载量。采用SPSS17.0统计学软件进行统计分析,并进行Spearman相关系数分析。结果CD3^(+),CD4^(+)和CD8^(+)T细胞数,CD4^(+)/CD8^(+)比值在各组中的差异均具有统计学意义(H=40.758,104.279,9.637和101.770,均P<0.05),组间两两比较结果表明,与健康对照组相比,TB组CD3^(+)和CD8^(+)T细胞数明显降低,差异均有统计学意义(Z=-2.520,-2.972,P=0.012,0.003);HIV组和HIV/TB组CD3^(+),CD4^(+)T细胞数以及CD4^(+)/CD8^(+)比值均明显降低(Z=-7.391~-4.325,均P=0.000)。与TB组相比,HIV组CD3^(+),CD4^(+)T细胞数和CD4^(+)/CD8^(+)比值均明显降低,差异均有统计学意义(Z=-2.138,-7.032和-7.380,P=0.032,0000和0.003),但CD8^(+)T细胞数明显升高(Z=-2.463,P=0.014);而HIV/TB组CD3^(+)和CD4^(+)T细胞数以及CD4^(+)/CD8^(+)比值均明显降低,差异均有统计学意义(Z=-3.865,-6.907和-6.759,均P=0.000)。与HIV组相比,HIV/TB组的各项流式指标及HIV RNA载量差异均无统计学意义(均P>0.05)。HIV RNA载量与CD3^(+),CD4^(+),CD8^(+)T细胞数以及CD4^(+)/CD8^(+)比值均呈显著负相关(r分别为-0.327,-0.370,-0.296和-0.327,均P<0.05)。结论HIV/TB并发感染患者外周血CD3^(+),CD4^(+)T细胞数和CD4^(+)/CD8^(+)比值均明显降低。无论有无并发TB感染,HIV感染者的细胞免疫功能均随着病毒载量的升高而显著降低。
Objective To explore the expression of T lymphocytes in peripheral blood and its correlation with HIV RNA load in HIV/TB co-infected patients.Methods Totally 38 HIV/TB co-infected patients treated in Nanjing Public Health Medical Center from June 2018 to June 2020 were selected as the HIV/TB group.Another 39 HIV/AIDS patients,35 TB patients and 35 cases of healthy people in the same period were randomly selected as control groups.Flow cytometry was used to detect CD3^(+),CD4^(+),CD8^(+)T cell count and CD4^(+)/CD8^(+)ratio in each group.Fluorescent PCR quantitative method was used to detect the HIV RNA load.Statistical analysis was carried out by using SPSS17.0 statistical software,and Spearman correlation coefficient was analyzed.Results There were significant differences in CD3^(+),CD4^(+)and CD8^(+)T cell count and the ratio of CD4^(+)/CD8^(+)in each group(H=40.758,104.279,9.637 and 101.770,all P<0.05).Further pairwise comparison showed that CD3^(+)and CD8^(+)T cell count in the TB group were significantly decreased than that in the healthy control group,the differences were statistically significant(Z=-2.520,-2.972,P=0.012,0.003).CD3^(+),CD4^(+)T cell count and the ratio of CD4^(+)/CD8^(+)were significantly decreased in HIV group and HIV/TB group,the differences were statistically significant(Z=-7.391~-4.325,all P=0.000).Compared with TB group,CD3^(+),CD4^(+)T cell count and the ratio of CD4^(+)/CD8^(+)were significantly decreased,the differences were statistically significant(Z=-2.138,-7.032,-7.380,P=0.032,0.000,0.003),but CD8^(+)T cell count was significantly increased in HIV group(Z=-2.463,P=0.014).However,CD3^(+)and CD4^(+)T cell count and the ratio of CD4^(+)/CD8^(+)decreased significantly in HIV/TB group,the differences were statistically significant(Z=-3.865,-6.907,-6.759,all P=0.000).Compared with the HIV group,there was no statistically significant differences in flow parameters and HIV RNA load in HIV/TB group(all P>0.05).CD3^(+),CD4^(+),CD8^(+)cell count and the ratio of CD4^(+)/CD8^(+)were negativ
作者
李雪
丁艳
黄玲
严加来
LI Xue;DING Yan;HUANG Ling;YAN Jia-lai(Department of Clinical Laboratory,Affiliated Nanjing Hospital of Nanjing University of Traditional Chinese Medicine&Nanjing Second Hospital,Nanjing Public Health Medical Center,Nanjing 210003,China;Department of Laboratory Medicine,Anhui Medical College,Hefei 230601,China)
出处
《现代检验医学杂志》
CAS
2022年第1期88-91,124,共5页
Journal of Modern Laboratory Medicine
