HIV/AIDS患者外周血T淋巴细胞亚群与中医证候的相关性分析

Relation between Peripheral Blood T lymphocyte Subsets and Chinese Medicine Syndrome in HIV/AIDS Patients

目的探讨人类免疫缺病毒/艾滋病(HIV/AIDS)患者外周血T淋巴细胞亚群与中医证候的相关性。方法采用艾滋病中医四诊信息采集表对133例HIV/AIDS患者进行临床调查与12个月的随访,使用人机结合的方法对四诊信息进行辨证分型,并同时监测T淋巴细胞亚群CD4+、CD8+计数,分析T淋巴细胞亚群各项指标与中医证候的相关性。结果 HIV/AIDS患者入组时出现频率居前4位的中医证型为肝郁气滞、气阴两虚、脾气虚弱、肝胃不和;随访12个月后出现频率居前4位的中医证型为肝郁气滞、气阴两虚、脾气虚弱、脾肾阳虚。其中入组时肝胃不和证患者的CD4+、CD8+计数均高于脾气虚弱证和气阴两虚证患者(P<0.05或P<0.01),肝郁气滞证患者CD8+计数高于脾气虚弱证患者(P<0.01);随访12个月后CD4+、CD8+计数在HIV/AIDS不同证型的患者之间比较差异无统计学意义(P>0.05)。入组时和高效抗逆转录病毒(HAART)治疗12个月后HIV/AIDS不同基本证型患者CD4+T淋巴细胞免疫重建差异均无统计学意义(P>0.05);初始CD8+计数分层与HAART治疗12个月后的免疫学应答情况的关联系数r=0.384,具有统计学意义(P<0.001)。结论 AIDS患者外周血T淋巴细胞亚群CD4+、CD8+计数与中医证型密切相关。

Objective To analyze the relation between peripheral blood T lymphocyte subsets and Chinese medicine syndrome in human immunodeficiency virus/acquired immune deficiency syndrome （HIV/AIDS） patients. Methods Totally 113 HIV/AIDS patients were investigated and followed up for 12 months. Man-machine system was used to identify the syndromes according to the diagnostic materials. CD4^＋ counts and CD8^＋ counts were monitored. The relation between peripheral blood T lymphocyte subsets and Chinese medicine syndrome was analyzed. Results At the beginning, the top four Chinese medicine syndromes were liver depression and qi stagnation syndrome, qi-yin deficiency syndrome, spleen qi deficiency syndrome and liver-stomach disharmony syndrome. After 12 months of follow-up, the top four Chinese medicine syndromes were liver depression and qi stagnation syndrome, qi-yin deficiency syndrome, spleen qi deficiency syndrome and spleen-kidney yang deficiency syndrome. At the beginning, CD4^＋ and CD8^＋ counts in liver-stomach disharmony syndrome were significantly higher than those in spleen qi deficiency syndrome and qi-yin deficiency syndrome （P〈0. 05 or P〈0. 01）, and CD8^＋ counts in liver depres- sion and qi stagnation syndrome were significantly higher than that in spleen qi deficiency syndrome （P〈0.01）. After 12 months of follow-up, there was no significant difference between syndromes in CD4^＋ and CD8^＋ counts （P〈0.05）. There was no significant difference in immune reconstitution of CD4＋ of all syndromes before and after highly active antiretroviral treatment （P〈0.05）. There was statistical significance in correlation coefficient of initial CD8^＋ counts stratification and immunological response 12 months later （r=0. 384, P〈0. 00D. Conclusion The CD4^＋ and CD8^＋ counts in peripheral blood T lymphocyte subsets are closely related to Chinese medicine syndrome in AIDS patients.