河南省116例首诊艾滋病患者抗病毒治疗免疫学效果评价

The change of CD4^+ T-lymphocyte cell count with anti-virus treatment in 116 newly diagnosed AIDS patients,Henan

目的分析河南省2009年首诊为艾滋病(AIDS)后随即接受抗病毒治疗的患者CD4+T淋巴细胞计数的变化情况。方法收集"河南省艾滋病检测实验室网络数据库"登记的116例河南省2009年首诊为AIDS后当年即接受抗病毒治疗的患者资料,将其按照治疗前CD4+T淋巴细胞数分成3组(<20个/μl,20~99个/μl和100~350个/μl),使用SPSS 14.0软件对患者治疗前、治疗后约2个月及5个月的CD4+T淋巴细胞数进行统计学分析。结果首诊后接受治疗的3组患者在治疗约2个月后CD4+T细胞计数同治疗前比较都有提高[<20个/μl组:(84.93±64.33)个/μlvs(9.39±5.10)个/μl,P=0.000;20~99个/μl组:(178.71±135.34)个/μlvs(46.62±18.71)个/μl,P=0.001;100~350个/μl组:(316.81±128.81)个/μlvs(197.66±67.59)个/μl,P=0.002],但是在治疗5个月后3组患者CD4+T细胞计数同治疗2个月时比较差异均无统计学意义。治疗前CD4+T细胞基线低的组达到的治疗效果较差。结论早发现、早治疗仍应是河南省开展AIDS防治的工作重点,同时应进一步加强首诊患者的随访和管理。

Objective To analyze the change of CD4＋ T-lymphocyte cell count with antiretroviral therapy（ART） in newly diagnosed AIDS patients.Methods One hundred and sixteen newly diagnosed AIDS patients were under ART treatment in Henan,2009.We categorized the patients into three groups by CD4＋T cell counts before ART,the group with CD4＋T cell counts of 100-350 cells/μl,20-99 cells /μl and lower than 20 cells/μl,respectively.The CD4 cell counts were measured again after 2 and 5 months of ART treatment.The analysis of variance（ANOVA） was used to compare the changes of CD4 cell counts for different groups by SPSS 14.0.Results The mean values of CD4 cell count were significantly increased after 2 months of ART treatment for newly diagnosed AIDS patients with prior CD4 counts of 100-350 cells/μl[from（197.66±67.59）/μl to（316.81±128.81）/μl],20-99 cells/μl[from（46.62±18.71）/μl to（178.71±135.34）/μl]and lower than 20 cells/μl[from（9.39±5.10）/μl to（84.93±64.33）/μl],respectively（P〈0.05）.However,there was no additional improvement after another 3 months treatment in any of the three groups.ART treatment efficacy was poor in AIDS patients with low CD4 counts before the therapy.Conclusions The early detection and treatment of HIV infection is critical for the efficacy of ART.