艾滋病患者免疫学指标、外周血组分与症状体征之间关系的回顾性研究

Relationship among immune indexes,peripheral blood components,symptoms and signs in AIDS patients

目的研究艾滋病患者免疫学指标、外周血组分和症状体征之间的关系,为临床诊治提供参考依据。方法坦桑尼亚中医药治疗艾滋病(AIDS)的病例资料249例,对其白细胞计数(WBC)、血红蛋白(Hb)、淋巴细胞(LY)、LY%,CD4+、CD4+%、CD8+、CD8+%、CD4/CD8+以及11项症状体征之间的关系进行统计学分析。结果不同CD4+分组LY、WBC3组之间两两差异极显著,LY%3组之间差异不显著;随着CD4+计数的下降,LY、LY%、WBC、Hb呈明显下降趋势,3个分组中CD4+计数与LY细胞计数均呈正相关,当CD4+<200/mm3时CD4+计数与LY%、WBC也呈显著正相关,在另外2个分组没得出显著相关性,Hb与CD4+计数也未看到显著相关性;按照CD4+分期3组的症状总积分随CD4+的降低而升高,特别是CD4+<200/mm3组与后两组总积分有显著差异;3组的9项症状体征的积分随着CD4+细胞数的下降而升高,与CD4+、CD4+/CD8+、CD4+%都有显著负相关性。结论LY细胞计数也可以看作是衡量患者免疫功能的一项重要指标;除CD4+计数外,CD4+/CD8+、CD4+%对于疾病的病情进展也是有一定意义的,而CD8+%、CD8+计数的意义并不明显。

Objective To study the relationships among immune indexes, the components of peripheral blood, symptoms and signs in AIDS patients and to provide the evidences for the clinical diagnosis and treatment. Method The clinical materials of 249 AIDS cases of Tanzania were analyzed statistically on the relationship between 11 symptoms and signs and their indexes of white blood cell count （WBC）, hemoglobin（Hb）, lymphocytes（LY）, LY%, CD4^＋, CD4^＋%, CD8^＋, CD8^＋% and CD4^＋/CD8^＋ Result The indexes of LY and WBC in different CD4^＋ phases were greatly different between the members of three groups, while LY% was not different. Along with CD4^＋ cell count decreasing, the indexes of LY, LY%, WBC and Hb tended to induce obviously. In three phases CD4^＋ cell count and LY count were correlated. When CD4^＋ cell count was below 200/mm^3, CD4^＋ cell count and LY% or WBC was correlated significantly. In other two phases, in CD4^＋ cell count, LY%, WBC, Hb and CD4^ ＋ cell count there was no correlation observed. The total symptom integrals in three groups according to CD4^＋ phases were increased along with the decrease of CD4^＋ cell count, in the group with CD4^＋ cell count below 200/mm^3, the total integral was significantly different from other two groups. The integrals of 9 symptoms and signs in three groups were increased along with the decrease of CD4^＋ cell count and there was a significant deference between the members of three groups, which was negatively related to CD4^＋, CD4^＋/CD8^＋ and CD4^＋%. Conclusion LY count is one of important indexes for evaluating the immunity of AIDS patient. Besides of CD4^＋ cell count, CD4^＋/CD8^＋ and CD4^＋ % are also significant to the development of AIDS. The CD8^＋% and CD8^＋ count are not significant.