摘要
目的探讨云南地区结核病患者合并感染HBV、HCV、HIV中合并感染率、免疫功能及耐药性状况。方法收集2020年4月至2023年3月昆明市第三人民医院收治的2271例云南地区结核病患者进行HBV、HCV、HIV血清学检测,同时进行淋巴细胞检测及结核菌的耐药基因检测,分析结核病分别感染HBV、HCV、HIV的感染率、免疫功能及耐药性。结果2271例结核病患者中,结核病合并HBV感染499例,感染率21.97%;合并HCV感染196例,感染率8.63%;合并HIV感染166例,感染率7.31%;单纯结核患者1410例,占比62.09%。结核病合并HBV、HCV、HIV感染率在不同年龄组比较,差异具有统计学意义(P<0.01)。结核病合并HBV、HCV患者中CD3^(+)、CD4^(+)和CD8^(+)T细胞的绝对数量表达较高,且两者的差异均具有统计学意义(P<0.05);结核病合并HIV患者CD3^(+)、CD4^(+)T细胞的绝对数量表达较低,CD8^(+)T细胞的绝对数量表达上升,两者的差异具有统计学意义(P<0.01)。CD3^(+)、CD4^(+)、CD8^(+)T细胞绝对数量在结核合并HIV的女性患者中表达较高,且差异均具有统计学意义(P<0.05);各年龄段中,结核合并HIV患者CD3^(+)、CD8^(+)T细胞绝对数量在46~65岁组最低,差异均有统计学意义(P<0.05)。2271例结核病患者中,耐任意1种一线药(单耐药)有391例,总体耐药率17.22%;其中,合并HBV耐药52例,耐药率10.42%;合并HCV耐药10例,耐药率5.10%;合并HIV耐药40例,耐药率24.10%;单纯结核患者耐药289例,耐药率20.50%。其中最多的是单耐药耐利福平33例,占19.88%。结论云南地区结核及合并HBV感染率最高,结核合并HIV患者的免疫功能最差,结核合并HIV的耐药率最高,单耐药以耐利福平最多;结核属于慢性消耗性疾病,免疫功能较一般人群差,易合并HBV感染,结核患者感染HIV有加重免疫功能减低及耐药性产生的趋势。
Objective To explore the co-infection rate,immune function and drug resistance status among tuberculosis patients co-infected with HBV,HCV and HIV in Yunnan.Methods A total of 2271 TB patients in Yunnan province admitted to the Third People's Hospital of Kunming from April 2020 to March 2023 were collected for HBV,HCV,HIV serological tests,lymphocyte tests and drug resistance gene detection,and analysis of TB infection of HBV,HCV,HIV infection,immune function and resistance.Results Among the 2271 TB patients,499 cases were infected with TB and HBV,the infection rate was 21.97%.196 cases were infected with HCV,the infection rate was 8.63%.166 cases were infected with HIV,the infection rate was 7.31%.There were 1410 patients with simple tuberculosis,accounting for 62.09%.The infection rates of tuberculosis combined with HBV,HCV and HIV were statistically significant in different age groups(P<0.01).The absolute number expression of CD3^(+),CD4^(+)and CD8^(+)T cells was higher in TB patients with HBV and HCV,and the differences between the two were statistically significant(P<0.05).The absolute number expression of CD3^(+)and CD4^(+)T cells was lower in TB patients with HIV,and the absolute number expression of CD8^(+)T cells was increased,and the difference between the two was statistically significant(P<0.01).The absolute number of CD3^(+),CD4^(+)and CD8^(+)T cells was higher in female patients with tuberculosis and HIV,and the differences were statistically significant(P<0.05).In all age groups,the absolute number of CD3^(+)and CD8^(+)T cells in tuberculosis patients with HIV was the lowest in 46-65 years old group,and the differences were statistically significant(P<0.05).Among the 2271 TB patients,391 were resistant to any first-line drug(single drug resistance),and the overall drug resistance rate was 17.22%.Among them,52 cases were combined with HBV drug resistance,the resistance rate was 10.42%.There were 10 cases with HCV drug resistance,the drug resistance rate was 5.10%.40 cases were combined with HIV drug
作者
王晓燕
李娅
何成禄
王霖
马志强
万鑫蕊
WANG Xiaoyan;LI Ya;HE Chenglu;WANG Lin;MA Zhiqiang;WAN Xinrui(Dept.of Medical Laboratory,The 1st Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650032;Dept.of Laboratory,The 3rd People’s Hospital of Kunming,Kunming Yunnan 650301,China)
出处
《昆明医科大学学报》
CAS
2023年第12期51-58,共8页
Journal of Kunming Medical University
基金
国家自然科学基金资助项目(82160696)
昆明市卫健委卫生科研基金资助项目(2022-11-01-011,2022-11-01-004)
昆明市卫生科技人才培养“千”工程基金资助项目[2022-SW(后备)-70,2022-SW(后备)-85]
昆明市卫生科技人才培养医学技术中心建设基金资助项目[2022-SW(技)-21]。
