血清IFN-γ和IL-10及免疫球蛋白与艾滋病患者机会性感染的关系研究

Relationship between serum IFN-γ,IL-10 and gamma immunoglobulin with opportunistic infections in patients with HIV/AIDS

目的研究分析血清γ-干扰素(IFN-γ)、白细胞介素-10(IL-10)及免疫球蛋白与人类免疫缺陷病毒(HIV)/艾滋病(AIDS)患者机会性感染的关系。方法选取2015年6月-2016年6月收治的AIDS患者50例,采用酶联免疫吸附法测定血清中IFN-γ、IL-10及免疫球蛋白水平。结果 50例HIV/AIDS患者中,机会性感染40例占80.00%,单一机会性感染11例占27.50%,2种及以上机会性感染29例占72.50%;机会性感染组患者IL-10、免疫球蛋白G(IgG)分别为(95.55±158.41)、(28.83±3.24)pg/ml,均显著高于未感染患者(10.22±19.10)、(11.24±2.22)pg/ml(P<0.05),而IFN-γ(5.81±1.32)pg/ml则低于未感染患者(8.62±1.01)pg/ml,差异有统计学意义(P<0.05),肺孢子菌感染患者IL-10为(19.71±27.82)pg/ml,均显著低于未感染患者(71.89±161.02)pg/ml(P<0.05);肺孢子菌感染患者、结核分歧杆菌、马尔尼菲青霉菌、其他真菌感染患者IgG水平均高于未感染患者(P<0.05);机会性感染组患者IgA与IgM水平与无感染患者,差异无统计学意义;50例患者中,好转39例,恶化或无变化7例,死亡4例。结论血清IL-10、IFN-γ与HIV/AIDS患者机会性感染的发生密切相关,低水平IL-10可降低机体对肺孢子菌的清除能力,IL-10与IFN-γ对疾病预后无明显关系。

OBJECTIVE To investigate the relationship between serum IFN-γ,IL-10 and gamma immunoglobulin with opportunistic infections in patients with human immunodeficiency virus（HIV）/（AIDS）.METHODS A total of 50 cases of HIV/AIDS patients from Jun.2015 to Jun.2016 were selected as the research objects,and enzymelinked immunosorbent assay（ELISA）was used to determine the serum levels of IFN-γ,IL-10 and gamma immunoglobulin.RESULTS Among 50 cases of HIV/AIDS patients,40 cases had opportunistic infection,accounting for80%,including 11 cases of single opportunistic infections（27.50%）,and 29 cases of 2 or more than 2 kinds of opportunistic infections（72.50%）.The levels of IL-10 and IgG in the patients with opportunistic infections were（95.55±158.41）and（28.83±3.24）pg/ml,which were higher than（10.22±19.10）and（11.24±2.22）pg/ml in uninfected group（P〈0.05）,and the IFN-γlevel in the patients with opportunistic infections was（5.81±1.32）pg/ml,which was lower than（8.62±1.01）pg/ml in uninfected patients,and the difference was significant（P〈0.05）.IL-10 in the patients with Pneumocystis infection was（19.71±27.82）pg/ml,which was lower than（71.89±161.02）pg/ml in uninfected group（P〈0.05）.IgG levels in patients with Pneumocystis infection,Mycobacterium tuberculosis,Penicillium marneffei and other fungi infection were higher than that in uninfected group（P〈0.05）.IgA and IgM levels in patients of opportunistic infection group and uninfected group had no significant difference.Among 50 cases of patients,39 cases were improved,7 cases were deterioration or no change,and 4 cases died.CONCLUSION Serum IL-10 and IFN-γmay be closely related to the occurrence of opportunistic infections in HIV/AIDS patients,low levels of IL-10 can reduce the body＇s ability to remove Pneumocystis,and IL-10 and IFN-γhave no obvious relation with disease prognosis.