摘要
目的探讨艾滋病(AIDS)合并肺结核(PTB)患者外周血中辅助性T细胞17(Th17)/调节性T细胞(Treg)、CD4^(+)T淋巴细胞水平对预后的影响。方法选取2019年1月-2020年6月在本院接受治疗的80例AIDS合并PTB患者作为研究对象,经随访统计所有患者预后(病死)情况,并根据结果分为死亡组与存活组,同时选取同期医院收治的80例单纯HIV感染者,作为单纯HIV感染组。设计基线资料统计表,详细统计死亡组与存活组患者的基线资料,重点分析治疗前外周血中Th17/Treg、CD4^(+)T淋巴细胞水平对AIDS合并PTB患者预后的影响。结果80例AIDS合并PTB患者经治疗后随访,病死23例,病死率为28.75%(23/80),纳入死亡组。死亡组外周血Th17、Th17/Treg水平依次高于存活组与单纯HIV感染组,且存活组高于单纯HIV感染组,死亡组外周血Treg、CD4^(+)T水平依次低于存活组与单纯HIV感染组,且存活组低于单纯HIV感染组,差异有统计学意义(P<0.05),死亡组与存活组患者的其他资料比较差异无统计学意义(P>0.05);经Cox回归分析,结果显示,外周血Treg、CD4^(+)T淋巴细胞水平较低,外周血Th17、Th17/Treg过表达可能是AIDS合并PTB患者治疗后预后不良的危险因子(P<0.05);绘制ROC曲线发现,治疗前外周血中Th17/Treg、CD4^(+)T淋巴细胞水平预测AIDS合并PTB患者治疗后预后不良风险的AUC>0.70,有一定的预测价值。结论AIDS合并PTB患者预后不良可能与治疗前外周血中Th17/Treg过表达、CD4^(+)T淋巴细胞低水平有关。
Objective To investigate the expression of helper T cell 17(Th17)/regulatory T cells(Treg),CD4+T lymphocytes in peripheral blood of patients with acquired immunodeficiency syndrome(AIDS)complicated with pulmonary tuberculosis(PTB).Methods A total of 80 patients with AIDS complicated with PTB who received treatment in our hospital from January 2019 to June 2020 were selected as the research subjects,the prognosis results(death from illness)of all patients was recorded after follow-up and divided them into the death group and the survival group.At the same time,80 patients with only HIV infection in the same period were selected as the HIV infection group.The baseline data were recorded in detail,the influence of Th17/Treg,CD4^(+)T lymphocytes in peripheral blood on the prognosis of patients with AIDS complicated with PTB was mainly analyzed.Results All patients under the followed up,23 cases died,the mortality rate was 28.75%(23/80).The levels of Th17 and Th17/Treg in peripheral blood of the death group were higher than those of the survival group and the HIV infection group,and the survival group was higher than that of the HIV infection group,while the levels of Treg and CD4^(+)T in peripheral blood of death group were lower than those of survival group and HIV infection group,and the survival group was lower than that of the HIV infection group,the differences were statistically significant(P<0.05),there was no statistical significant difference in comparison of other data of patients between the death group and the survival group(P>0.05);the results of Cox regression analysis showed that,low expression of Treg,CD4^(+)T lymphocytes and overexpression of Th17 and Th17/Treg in peripheral blood might be risk factors for poor prognosis in patients with AIDS complicated with PTB(P<0.05).The ROC curve showed that the AUC of levels of Th17/Treg,CD4^(+)T lymphocytes in peripheral blood before treatment in predicting the risk of poor prognosis in patients with AIDS complicated with PTB after treatment were all>0.70,whic
作者
李榜龙
刘意心
李小玉
欧阳青
LI Banglong;LIU Yixin;LI Xiaoyu;OUYANG Qing(Department of Tuberculosis,the First Hospital of Changsha,Changsha 421001,China;Department of Infection and Immunity,the First Hospital of Changsha,Changsha 421001,China)
出处
《中国皮肤性病学杂志》
CAS
CSCD
北大核心
2022年第7期791-796,823,共7页
The Chinese Journal of Dermatovenereology
基金
“十三五”艾滋病和病毒性肝炎等重大传染病防治科技重大专项(2017ZX10202101-001-014)。
