杨水秀,国果
YANG Shuixiu,GUO Guo

• 1:贵州医科大学基础医学院
• 2:贵阳市公共卫生救治中心血透室
• 3:贵州医科大学

摘要(Abstract)：

目的:探讨人类免疫缺陷病毒(HIV)感染者外周血CD4~+T淋巴细胞数与血常规、肾功能及血淀粉酶的关系。方法:326例HIV感染者为研究组,根据CD4~+T淋巴细胞计数分为3组(A组CD4~+T淋巴细胞数<200个/μL、B组CD4~+T淋巴细胞数200～500个/μL、C组CD4~+T淋巴细胞数>500个/μL),另选取同期健康体检者100例为对照组;比较对照组和研究组ART前,研究组ART前后的CD4~+T淋巴细胞计数、白细胞计数(WBC)、淋巴细胞计数(LY)、淋巴细胞百分比(LY%)、中性粒细胞计数(Neu)、中性粒细胞百分比(Neu%)、尿素氮(BUN)、肌酐(CRE)、胱抑素-C(Cys-C)、β2-微球蛋白(β2-MG)、血淀粉酶(AMY),Pearson相关分析研究组患者治疗后CD4~+T淋巴细胞计数与这些指标的相关性。结果:与对照组比较,治疗前3组HIV感染者的WBC、LY、LY%均降低,β2-MG均升高,差异有统计学意义(P<0.05);治疗前3组HIV感染者间比较,WBC、LY、LY%随CD4~+T淋巴细胞计数减少而下降,Neu%、β2-MG随CD4~+T淋巴细胞计数减少而升高,差异有统计学意义(P<0.05);ART 6月时,3组HIV感染者LY、LY%较治疗前均升高,Neu%、Cys-C、β2-MG较治疗前均降低,A组β2-MG水平高于B组和C组,差异有统计学意义(P<0.05);Pearson相关分析结果显示,A组与B组的CD4~+T淋巴细胞与WBC、LY、LY%呈正相关(P<0.05),与Neu%、Cys-C、β2-MG呈负相关(P<0.05)。结论:HIV感染者外周血CD4~+T淋巴细胞计数与血常规、肾功能指标具有一定相关性,检测血常规、肾功能指标对制定治疗方案、监测疗效、及时调整诊疗方案具有一定的指导意义。
Objective: To investigate the changes of white blood cells(WBC), lymphocyte count(LY), lymphocyte percentage(LY%), neutrophil counts(Neu), percentage of neutrophils(Neu%), urea nitrogen(BUN), creatinine(CRE), Cystatin-C(Cys-C), β2-micro globulin(β2-MG) and serum amylase(AMY), and its correlation with different immune levels of patients with HIV. Methods: The test data of 326 cases of HIV infected people before and after 6 months' ART was collected including CD4~+T-lymphocyte counts, WBC, LY, LY%, Neu, Neu%, BUN, CRE, Cys-C, β2-MG and serum AMY. Based on detection of CD4~+T-lymphocyte counts before treatment, they were divided into three groups: Group A(CD4~+T-lymphocyte counts<200/μL), Group B(CD4~+T-lymphocyte counts 200～500/μL) and Group C CD4~+T-lymphocyte counts>500/μL). Results: The levels of WBC, LY and LY% in all groups decreased,while β2-MG increased compared with the control group before ART(P<0.05).With the decrease of immune level(CD4~+T-lymphocyte counts), the levels of WBC, LY and LY% of HIV infection in all groups showed a downward trend(P<0.05), β2-MG gradually increased(P<0.05). After 6-months' ART, the levels of β2-MG in Group A were higher than those of Group B and Group C(P<0.05). LY and LY% after ART were higher than before ART, while the levels of Neu%,Cys-C and β2-MG declined after ART(P<0.05). Pearson analysis showed that the CD4~+T-lymphocyte counts in HIV patients were positively correlated with LY and LY%, and negatively correlated with GR%,Cys-C and β2-MG.The levels of CD4~+T-lymphocyte counts were not significant correlated with WBC, Neu, BUN, CRE and AMY. Conclusion: Monitoring the above indicators can provide certain clinical guiding significance for the treatment options, adjust and monitoring efficacy.

关键词(KeyWords)： HIV感染;CD4~+T淋巴细胞计数;血常规;肾功能;β2-微球蛋白;胱抑素-C;淀粉酶
HIV infection;CD4~+T-lymphocyte counts;blood routine;renal function;β2-micro globulin;Cystatin-C;amylase

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金项目(81760647)

作者(Author): 杨水秀,国果
YANG Shuixiu,GUO Guo

DOI: 10.19367/j.cnki.1000-2707.2019.11.012

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