HIV感染者/AIDS患者外周血总淋巴细胞数与CD4+T淋巴细胞数相关性分析

Analysis of the correlation between total lymphocyte count and CD4 +T lymphocyte count in peripheral blood of HIV / AIDS patients

目的探讨HIV/AIDS患者外周血总淋巴细胞数(TLC)与CD4+T淋巴细胞数的相关性,以及将TLC作为预测CD4+T淋巴细胞计数的可行性。方法分析314例HIV/AIDS患者TLC和CD4+T淋巴细胞数相关性,根据灵敏度、特异度、阳性预测值、阴性预测值和约登指数五项指标,估计预测CD4+T淋巴细胞数<100个/μl、<200个/μl和<350个/μl的TLC的最佳临界值。采用SPSS 13.0软件进行相关分析和回归分析。结果CD4+T淋巴细胞与TLC显著正相关(r=0.703,P<0.001)。用TLC<1 300个/μl预测CD4+T<100个/μl灵敏度为79.07%,特异性为88.19%,阳性预测值为51.52%,阴性预测值为96.37%,约登指数为0.673;用TLC<1 700个/μl预测CD4<200个/μl灵敏度为80.68%,特异性为80.09%,阳性预测值为61.21%,阴性预测值为91.41%,约登指数为0.608;用TLC<1 900个/μl预测CD4<350个/μl灵敏度为74.05%,特异性为76.92%,阳性预测值为76.47%,阴性预测值为74.53%,约登指数为0.510。结论在无条件检测CD4+T淋巴细胞计数的情况下,可用TLC预测CD4+T淋巴细胞计数,监测HIV感染者疾病的进展情况,粗略判断抗病毒治疗的疗效。分别以TLC<1 300个/μl、<1 700个/μl和<1 900个/μl预测CD4<100个/μl、<200个/μl和<350个/μl是比较合适的。

Objective To study the correlation between total lymphocyte count（TLC） and CD4^＋T lymphocyte count in HIV/ AIDS patients, and evaluate the feasibility of TLC in predicting CD4^＋T lymphocyte count. Methods Correlation between TLC and CD4^＋T lymphocyte count were analyzed by SPSS13.0 Software in 314 samples collected from HIV/AIDS patients. According to the sensitivity, specificity, positive predictive value （PPV）, negative predictive value （NPV） and Youden index, the optimal critical value were predicted that CD4^＋T lymphocyte 〈100 cells/μl, CD4^＋T lymphocyte 〈200 cells/hal and CD4^＋T lymphocyte〈350 cell/μl. Results A significant positive correlation was noted between TLC and CD4^＋T lymphocyte counts（r=0.703,P〈0.001）. TLC 〈1 300 cells/μl had 79.07% sensitivity, 88.19% specificity, 51.52% PPV, 96.37% NPV and 0.673 Youden index for predicting CD4^＋T lymphocyte〈100 cells/μl. TLC〈1 700 cells/ μl had 80.68% sensitivity, 80.09% speeificity,61.21% PPV,91.41% NPV and 0.608 Youden index for predicting CD4^＋ T lymphocyte〈200 cells/μl. TLC〈1 900 cells/μl had 74.05% sensitivity, 76.92% specificity, 76.47% PPV, 91.41% NPV and 0.510 Youden index for predicting CD4^＋T lymphocyte〈350 cells/μl. Conclusions TLC may be used to predict the CD4^＋T lymphocyte count and monitor the disease progression and evaluate the effect about anti-virus treatment of AIDS patients in unconditional area. It is suitable to use TLC〈1 300 cells/μl, 〈1 700 cells/μl and 〈1 900 cells/μl to predict CD4^＋T lymphocyte 〈100 cells/μl, 〈200 cells/μl and 〈350 cells/μl, respectively.