高效抗逆转录病毒治疗对AIDS患者机体代谢及T淋巴细胞亚群的影响

Effect of Highly Active Antiretroviral Therapy on Body Metabolism and T Lymphocyte Subpopulation in AIDS Patients

目的:探讨高效抗逆转录病毒治疗(HAART)对获得性免疫缺陷综合征(AIDS)患者机体代谢及T淋巴细胞亚群的影响。方法:96例AIDS患者,分别采用HAART(实验组,48例)、或相同外形的安慰剂(对照组,48例)连续治疗12个月;比较2组患者治疗前及治疗12个月时的血清总胆红素(TBIL)、直接胆红素(DBIL)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、血肌酐(Scr)、尿素氮(BUN)、空腹血糖(FPG)、餐后2h血糖(2hPG)、总胆固醇(TC)、甘油三酯(TG)、高/低密度脂蛋白胆固醇(HDL-C/LDL-C)及全血中T淋巴细胞亚群CD4+、CD8+比例、Treg细胞及Th17细胞比例。结果:治疗后,对照组ALT水平及实验组TBIL、DBIL、ALT、AST水平均较治疗前显著升高(P<0.05,或P<0.01),且实验组ALT、AST水平显著高于对照组(P<0.01);治疗前后及2组间Scr、BUN水平比较,差异无统计学意义均无明显变化(P>0.05);治疗后实验组FPG、2hPG、TC、TG水平,CD4+及Th17细胞比例均显著高于治疗前及对照组(P<0.01);治疗后实验组CD8+及Treg细胞比例均显著低于治疗前及对照组(P<0.01)。结论:HAART可明显改善AIDS患者细胞免疫功能,但易引起患者肝功能紊乱。

Objective: To investigate the effect of highly active antiretroviral therapy (HAART) on body metabolism and T lymphocyte subpopulation in AIDS Patients. Methods: 96 patients with AIDS were selected and randomly divided into the experiment group and control group,48 cases in each group,for 12 month therapy.The experiment group was treated with HAART,the control group was given placebo with the same shape.Comparing following indicators and the proportion before and after treatment between the 2 groups: TBIL,DBIL,ALT,AST,Scr,BUN,FPG,2hPG,TC,TG,HDL-C/LDL-C and proportion of CD4+ and CD8+,proportion of Treg cell and Th17 in T lymphocyte subpopulation. Results: Compared with before treatment,the levels of ALT in the control group and the level of TBIL,DBIL,ALT,AST in the experiment group after treatment significantly increased ( P <0.05 or P <0.01),and the levels of ALT and AST in the experiment group were significantly higher than the control group ( P <0.01).There was no significant difference before and after treatment between the 2 groups in terms of Scr and BUN level ( P >0.05).The levels of FPG,2hPG and TC,TG,CD4+ and Th17 cell proportion in the experiment group after treatment were significantly higher than before treatment and the control group ( P <0.01).The proportions of CD8+ and Treg cells in experiment group were significantly lower than before treatment and the control group ( P <0.01). Conclusion: HAART can significantly improve the cellular immune function of AIDS patients,but it can easily lead to liver function disorder in patients.