人免疫缺陷病毒感染患者血清生化和炎性指标变化及临床意义

Changes of serum biochemical and inflammatory markers for patients with HIV infection and the clinical significance

目的探讨人免疫缺陷病毒(HIV)感染患者血清生化和炎性指标变化及临床意义,为HIV临床治疗提供参考。方法选取50例HIV感染患者(HIV组)及同期门诊行健康体检的50例健康人群(对照组)。检测血清谷氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TB)、直接胆红素(DB)、总蛋白(TP)、白蛋白(ALB)、尿素氮(BUN)、肌酐(Cr)、肌酸激酶同工酶(CK)、乳酸脱氢酶(LDH)、白细胞介素23(IL-23)、白细胞介素-27(IL-27)、白细胞介素32(IL-32)。结果 HIV组与对照组ALT、AST、TB、DB、TP、ALB、BUN、Cr比较差异无统计学意义(P>0.05),HIV组CK、LDH、IL-23、IL-27、IL-32比较差异有统计学意义(P<0.05);HIV组合并与未合并HBV和(或)HCV感染患者ALT、AST、TB、DB、TP、ALB、CK、LDH、IL-23、IL-27、IL-32比较差异有统计学意义(P<0.05),BUN、Cr比较差异无统计学意义(P>0.05);HIV组C期与A-B期患者ALT、AST、TB、DB、BUN、Cr、CK、LDH比较差异无统计学意义(P>0.05),TP、ALB、IL-23、IL-27、IL-32比较差异有统计学意义(P<0.05)。结论 HIV感染可引起患者促炎因子IL-23、IL-27、IL-32降低,合并HBV和(或)HCV感染时可出现明显的肝功能异常,HIV感染者病情严重程度、是否合并HBV和(或)HCV对肾功能指标影响轻微。

Objective To investigate the changes of serum biochemical and inflammatory markers for patients with human immunodeficiency virus（ HIV） infection and the clinical significance,so as to provide reference for the clinical treatment of HIV. Methods Fifty cases of HIV-infected patients（ HIV group） for the diagnosis and 50 healthy subjects（ control group） with health examination during the same period were chosen. The serum glutamate aminotransferase（ ALT）,aspartate aminotransferase（ AST）,total bilirubin（ TB）,direct bilirubin（ DB）,total protein（ TP）,albumin（ ALB）,blood urea nitrogen（ BUN）,creatinine（ Cr）,creatine kinase（ CK）,lactate dehydrogenase（ LDH）,interleukin-23（ IL-23）,interleukin-27（ IL-27） and interleukin-32（ IL-32） were detected. Results There were no statistically significant differences in ALT,AST,TB,DB,TP,ALB,BUN,Cr between the two groups（ P〈0. 05）. CK,LDH,IL-23,IL-27,IL-32 were indicated statistically significant differences（ P〈0. 05）. There were significant differences in ALT,AST,TB,DB,TP,ALB,CK,LDH,IL-23,IL-27,IL-32 between HIV combined with HBV and（ or） HCV infected patients and HIV not combined with HBV and（ or） HCV infected patients（ P〈0. 05）,while there were no significant differences in BUN,Cr between the two groups（ P〈0. 05）. Differences in ALT,AST,TB,DB,BUN,Cr,CK,LDH between the HIV phase C group and HIV phase A-B group showed no statistical significance（ P〈0. 05）. There were statistically significant differences in TP,ALB,IL-23,IL-27,IL-32（ P〈0. 05）. Conclusions HIV infection can cause the decrease of proinflammatory cytokine IL-23,IL-27,IL-32,when combined with HBV and（ or） HCV infection may cause significant abnormal liver function. Severity of HIV infection,whether HIV infection was combined with HBV and（ or） HCV infection has slight effect on renal function.