血液IFN-γ、IL-21、CXCR5及CD8^+T淋巴细胞与HIV感染病程进展的相关性

Analysis on the Correlation of Blood IFN-γ, IL-21, CXCR5, CD8^+T-lymphocytes and HIV Infection

目的:探讨血清干扰素-γ(IFN-γ)、白细胞介素-21(IL-21)、趋化因子CXCR受体5(CXCR5)水平及血液CD8^+T淋巴细胞数与HIV感染病程进展的相关性。方法:HIV抗体确诊阳性病人75例为研究组,根据血液CD4^+T淋巴细胞计数分为A组(CD4^+T<200个/μL)、B组(CD4^+T200~500个/μL)及C组(CD4^+T>500个/μL),另选取同期健康体检者25例为对照组;研究组于抗反转录病毒治疗(ART)前1天、ART后3个月时、健康对照组体检时采取空腹静脉血,采用流式细胞术检测CD4^+T、CD8^+T淋巴细胞计数,采用酶联免疫吸附法(ELISA)法检测血清IFN-γ、IL-21及CXCR5水平;采用Pearson相关分析HIV感染者各组所测指标与该疾病病程的相关性。结果:ART前IFN-γ、CXCR5及IL-21的水平比较,随着CD4^+T淋巴细胞计数逐渐降低,所测指标水平逐渐减少,A组<B组<C组,差异有统计学意义(P<0.01);ART后3个月时,各组HIV感染患者血清IFN-γ、CXCR5及IL-21水平比较,差异无统计学意义(P>0.05);各组HIV感染患者ART后血清IFN-γ、CXCR5及IL-21水平均较治疗前升高,差异有统计学意义(P<0.01);Pearson相关分析结果显示,HIV感染患者血清IFN-γ、CXCR5、IL-21水平与CD4^+T淋巴细胞、CD8^+T淋巴细胞计数呈正相关;IFN-γ、CXCR-5、IL-21水平与艾滋病病毒载量呈负相关,差异有统计学意义(P<0.05)。结论:HIV感染患者血清IFN-γ、CXCR5、IL-21水平与其疾病进展存在一定的相关性。

Objective:To investigate the changes of blood IFN-γ,CXCR5,IL-21 and CD8^+T-lymphocyte counts of HIV infected patients and their correlation with disease progression.Methods:75 cases with positive HIV antibody were selected as the study group and divided into three groups according to the detection of CD4^+T-lymphocyte before treatment:Group A(CD4^+T<200μL),Group B(CD4^+T 200~500μL)and Group C(CD4^+T>500μL).25 healthy people were selected as the control group.Peripheral blood was detected for the study group 1 day before effective antiretroviral therapy(ART)and in 3 months after treatment and for the control group in the physical examination.Flow cytometry was used to count CD4^+T,CD8^+T-lymphocytes,and PCR was used to quantify HIV RNA.The levels of IFN-γ,CXCR5 and IL-21 in serum were detected by ELISA.The correlation between the measured indexes and progression of disease was analyzed by linear correlation.Results:The levels of IFN-γ、CXCR5、IL-21 gradually decreased with the decrease of immune function before ART,namely,Group A<Group B<Group C(P<0.01).The difference was statistically significant(P<0.01).There was no significant difference on levels of IFN-γ,CXCR5 and IL-21 in all groups after treatment.The levels of IFN-γ,CXCR5 and IL-21 after treatment were higher than those before treatment(P<0.01).According to Pearson analysis,the levels of IFN-γ,CXCR5 and IL-21 were positively correlated with the CD8^+T-lymphocyte counts.The levels of IFN-γ,CXCR5 and IL-21 were negatively correlated with HIV load.Conclusion:The changes of IFN-γ,CXCR5 and IL-21 were related to HIV progression.