外周血淋巴细胞监测人类免疫缺陷病毒和获得性免疫缺陷综合症疗效评价

Changes in Total Lymphocyte Count as a Surrogate in Monitoring HIV/AIDS Patients

目的研究人类免疫缺陷病毒(HIV)感染者和获得性免疫缺陷综合症(AIDS)患者CD4+T淋巴细胞数变化(ΔCD4+T)和外周血淋巴细胞总数变化(ΔTLC)的相关性。探讨用ΔTLC预测ΔCD4+T在监测HIV/AIDS患者疾病进展以及高效抗逆转录病毒治疗(HAART)疗效的价值。方法回顾性分析20052008年确诊的91例HIV/AIDS患者的临床资料。结果ΔTLC与ΔCD4+T呈直线正相关(r=0.809,P<0.01),好于TLC与CD4+T的相关性(r=0.712,P<0.01)。分别用ΔTLC170、330、630、910个/μL细胞预测ΔCD4+T50、100、200、300个/μL细胞时具有较好的预测价值,各项评价指标符合率基本达到90%以上,显著高于相同时间下用TLC预测CD4+T计数的价值。结论应用ΔTLC预测ΔCD4+T,可比TLC更加直观、准确的反映HIV感染者疾病进展和评价AIDS患者HAART的疗效。

Objective To assess the utility of total lymphocyte count（TLC）changes（ΔTLC）in place of TLC to predict the development of HIV/AIDS.To investigate the monitoring value of ΔCD4^＋T on progress of HIV/AIDS and HAART which predicted by ΔTLC.Methods Clinical data of 91 patiens with HIV/AIDS diagnosed from 2005 to 2009 were retrospectively analyzed.Results A linear correlation was found between the value of ΔTLC and the value of CD4^＋T changes（ΔCD4^＋T）（r=0.809,P〈0.01）,which was better than the correlation between TLC and CD4^＋T（r=0.712,P〈0.01）.Using ΔTLC as 170,330,630,910 cells/μL,respectively for forecasting ΔCD4^＋T as 50,100,200,300 cells/μL,respectively,had a better predictive value with the area under ROC curve near to 0.9,significantly higher than using TLC for predicting CD4^＋T counts.Conclusion ΔTLC is more accurate than TLC to reflect the development of HIV/AIDS.