HIV感染者血液T淋巴细胞亚群表达水平的变化及其临床意义

Expression of serum T lymphocyte subsets in HIV-infected patients and its clinical significance

目的探究人类免疫缺陷病毒(HIV)感染者血液T淋巴细胞亚群的表达水平的变化及其临床意义,为患者的临床诊断提供指导。方法前瞻性选取西安市第八医院2018年1月至2019年5月收治的60例HIV感染患者作为观察组,另选取同期体检健康者60例为对照组。采用流式细胞仪技术检查两组受检者T淋巴细胞亚群表达情况。结果观察组和对照组受检者的T4[(382±110)/mm^3 vs(849±250)/mm^3]、T8[(1031±301)/mm^3 vs(579±150)/mm^3]细胞计数以及T4/T8比值[(0.42±0.01)/mm^3 vs(1.54±0.35)/mm^3]比较,差异均有显著统计学意义(P<0.01);观察组和对照组受检者的CD3^+[(1065.21±315.98)个/μL vs(1844.34±364.07)个/μL]、CD4^+[(492.95±145.17)个/μL vs(1104.17±152.21)个/μL]、CD4^+%[(27.15±7.17)%vs(36.87±8.41)%]、CD4^+/CD8^+[(0.38±0.02)vs(1.67±0.14)]比较,观察组明显低于对照组,CD8^+[(995.32±169.98)个/μL vs(583.34±169.11)个/μL]、CD8^+%[(63.87±7.78)%vs(33.34±8.31)%]比较,观察组明显高于对照组,差异均有显著统计学意义(P<0.01);观察组男性和女性患者的CD4^+[(14.34±4.17)个/μL vs(19.17±5.22)个/μL]、CD4^+/CD8^+[(0.28±0.01)vs(0.37±0.04)]比较,男性明显低于女性,CD8^+[(80.32±17.28)个/μL vs(70.34±10.76)个/μL]比较,男性明显高于女性,差异均有显著统计学意义(P<0.01);50岁以下与50岁以上患者的CD4^+[(14.95±4.06)vs(14.24±3.81)]、CD8^+[(76.32±10.24)vs(77.34±9.48)]、CD4^+/CD8^+[(0.29±0.03)vs(0.29±0.01)]比较差异均无统计学意义(P>0.05)。结论HIV感染者免疫系统受损,免疫功能异常,对HIV感染者进行T淋巴细胞亚群检测有利于诊断和评估免疫功能受损程度,从而能够为判断病情进程和诊疗提供临床参考。

Objective To explore the expression level and clinical significance of serum T lymphocyte subsets in patients with human immunodeficiency virus(HIV)infection,and to provide guidance for the clinical diagnosis of patients.Methods Sixty HIV-infected patients admitted to the Eighth Hospital of Xi’an City from January 2018 to May 2019 were prospectively selected as the observation group,and 60 healthy people were selected as the control group during the same period.Flow cytometry was used to examine the expression of T lymphocyte subsets in the two groups.Results There were statistically significant differences in T4,T8,and T4/T8 ratio between the observation group and the control group(P<0.01):T4,(382±110)/mm^3 vs(849±250)/mm^3;T8,(1031±301)/mm^3 vs(579±150)/mm^3;T4/T8 ratio,(0.42±0.01)/mm^3 vs(1.54±0.35)/mm^3.The levels of CD3^+,CD4^+,CD4^+%,CD4^+/CD8^+in observation group were significantly lower than those in the control group(P<0.01):CD3^+,(1065.21±315.98)cells/μL vs(1844.34±364.07)cells/μL;CD4^+,(492.95±145.17)cells/μL vs(1104.17±152.21)cells/μL;CD4^+%,(27.15±7.17)%vs(36.87±8.41)%;CD4^+/CD8^+,(0.38±0.02)vs(1.67±0.14);the CD8^+and CD8^+%in the observation group were significantly higher than those in the control group(P<0.01):CD8^+,(995.32±169.98)cells/μL vs(583.34±169.11)cells/μL;CD8^+%,(63.87±7.78)%vs(33.34±8.31)%.CD4^+,CD4^+/CD8^+in male patients in the observation group were significantly lower than those in female patients:CD4^+,(14.34±4.17)cells/μL vs(19.17±5.22)cells/μL;CD4^+/CD8^+,(0.28±0.01)vs(0.37±0.04);CD8^+in male patients were significantly higher than that in female patients(P<0.01):CD8^+,(80.32±17.28)cells/μL vs(70.34±10.76)cells/μL.There was no significant difference in CD4^+,CD8^+,CD4^+/CD8^+in patients under 50 years old and over 50 years old(P>0.05):CD4^+,(14.95±4.06)cells/μL vs(14.24±3.81)cells/μL;CD8^+,(76.32±10.24)cells/μL vs(77.34±9.48)cells/μL;CD4^+/CD8^+,(0.29±0.03)vs(0.29±0.01).Conclusion The immune system of HIV-infected people is damaged and the immune function is abnormal,and the detection of T lymphocyte subsets in HIV infected patients is helpful to diagnose and evaluate the degree of immune function impairment,which can provide clinical reference for judging the progress of disease and diagnosis and treatment.