HIV/AIDS患者中CD_4细胞计数与总淋巴细胞计数间相关性研究

Correlation study of total lymphocyte count and CD_4 count in HIV/AIDS patients

目的 评价总淋巴细胞计数与CD4细胞计数间的相关性。方法 回顾性分析了 2 2 6例艾滋病病毒(HIV)阳性患者共 330对同一天获得的CD4细胞计数与总淋巴细胞计数间的相关性 ,阳性预测值 (PPV)、敏感性、特异性分别在不同的总淋巴细胞计数范围对应于CD4细胞计数 <2 0 0个 /mm3 和CD4细胞计数 <35 0个 /mm3 时获得。结果 330对CD4细胞计数与总淋巴细胞计数之间存在相关性 (r =0 .5 2 8,P <0 .0 1) ,总淋巴细胞计数 <14 0 0个 /mm3 对应于CD4细胞计数 <2 0 0个 /mm3 有 70 .11%的阳性预测值 ,72 .6 1%的敏感性 ,88.4 6 %的特异性 ,总淋巴细胞计数 <190 0个 /mm3 对应于CD4细胞计数 <35 0个 /mm3 有 80 .97%的阳性预测值 ,70 .92 %的敏感性 ,74 .5 4 %的特异性。结论 总淋巴细胞计数可以作为评价患者患机会性感染的危险程度及何时开始药物治疗的一种低消费的监测手段。阳性预测值 (PPV)、敏感性、特异性分别在总淋巴细胞计数 <14 0 0个 /mm3 对应于CD4细胞计数 <2 0 0个 /mm3 和总淋巴细胞计数 <190 0个 /mm3 对应于CD4细胞计数 <35 0个 /mm3 时表现最为明显。

Objective To assess the correlation of total lymphocyte count (TLC) to CD_4 count in HIV-infected patients in order to determine a range of TLC cutoffs for opportunistic infection (OI) prophylaxis and initiation of highly active antiretroviral therapy (HAART). Method A retrospective study evaluating the correlation between CD_4 count and TLC in 226 individuals including inpatients and outpatients was performed. Positive predictive value (PPV),sensitivity and specificity of various TLC cutoffs were calculated for CD_4 count <200/mm 3 and <350/mm 3. Correlation and statistical indices are computed for all patients. Result A medium degree of correlation was noted between 330-paired CD_4 and TLC counts (r=0.528,p <0.01). TLC <1400/mm 3 had a 70.11% PPV and was 72.61% sensitive,88.64% specific for CD_4 <200/mm 3. TLC <1900/mm 3 had a 80.97% PPV and was 70.92% sensitive,74.54% specific for CD_4<350/mm 3. Conclusion TLC could serve as a low-cost tool for determining both a patient's risk of OIs and when to initiate HAART in resource-constrained settings. PPV,sensitivity and specificity maximally aggregated at TLC <1400/mm 3 for CD_4<200/mm 3 and TLC <1900/mm 3 for CD_4<350/mm 3.