外周血淋巴细胞计数在艾滋病患者HAART治疗中的变化及其对疗效的影响

Changes of peripheral blood lymphocyte count in patients with AIDS treated with HAART and its effect on the efficacy

目的研究外周血淋巴细胞计数在艾滋病(AIDS)患者高效抗反转录病毒治疗(HAART)中的变化,分析其对于疗效的影响。方法选取我院2018年6月至2019年9月收治的艾滋病患者120例作为观察组,给予HAART,选择同期100例门诊体检健康者作为对照组。检测并分析不同时段患者的CD4^(+)T淋巴细胞和B淋巴细胞计数,分析治疗后两种计数的相关性,并利用受试者工作特征曲线(ROC)分析B淋巴细胞最佳治疗切入点。结果(1)观察组治疗前后的CD4^(+)T及B淋巴细胞计数均低于对照组(P<0.05),观察组患者治疗1、3、6及12个月后的CD4^(+)T及B淋巴细胞计数均明显高于治疗前(P<0.05),且呈时间依赖性相关趋势;(2)与无效亚组比较,有效亚组治疗6个月、12个月的CD4^(+)T淋巴细胞计数均明显升高(P<0.05),与无效亚组比较,有效亚组治疗前后的B淋巴细胞均明显升高(P<0.05),有效亚组及无效亚组的CD4^(+)T淋巴细胞及B淋巴细胞计数均有高于治疗前(P<0.05),且呈时间依赖性相关趋势;(3)治疗12个月,观察组患者的ΔCD4^(+)T淋巴细胞与ΔB淋巴细胞呈明显正相关(r=0.396,P<0.05);(4)ROC曲线显示,治疗前外周血B淋巴计数在101.28个/μl时,曲线下面积为0.853,治疗有效的敏感度为81.93%,特异度为83.47%。结论HAART可明显提升艾滋病患者机体CD4^(+)T淋巴细胞和B淋巴细胞计数,同时治疗前B淋巴细胞计数对艾滋病患者HAART治疗效果有明显影响。

Objective To study the changes of peripheral blood lymphocyte count in patients with acquired immune deficiency syndrome(AIDS)treated with highly active antiretroviral therapy(HAART),and to analyze its effect on the efficacy.Methods A total of 120 patients with AIDS admitted to our hospital from June 2018 to September 2019 were selected as the observation group and given HAART,and 100 healthy people undergoing physical examination in the outpatient in the same period were selected as the control group.The CD4^(+)T-lymphocyte and B-lymphocyte counts of patients at different time periods were detected and analyzed,and the correlation between the two counts after treatment was analyzed.The optimal treatment cut-off point for B-lymphocyte was analyzed by using the receiver operating characteristic curve(ROC).Results(1)The CD4^(+)T-lymphocyte and B-lymphocyte counts in the observation group before and after treatment were lower than those in the control group(P<0.05).The CD4^(+)T-lymphocyte and B-lymphocyte counts in the observation group were significantly higher after 1,3,6 and 12 months of treatment compared with those before treatment(P<0.05),and there was a time-dependent correlation trend.(2)Compared with the ineffective subgroup,the CD4^(+)T-lymphocyte counts in the effective subgroup were significantl y higher after 6 and 12 months of treatment(P<0.05).Compared with the ineffective subgroup,the B-lymphocyte counts in the effective subgroup were significantly higher before and after treatment(P<0.05).After treatment,the CD4^(+)T-lymphocyte and B-lymphocyte counts in the effective and ineffective subgroups were increased to different degrees compared with those before treatment(P<0.05),and there was a time-dependent correlation trend.(3)Af ter 12 months of treatment,there was a significant positive correlation between theΔCD4^(+)T-lymphocyte andΔB-lymphocyte of patients in the observation group(r=0.396,P<0.05).(4)The ROC curve showed that,before treatment,the area under the curve was 0.853,the sensitivity and specificity of effective treatment was 81.93%and 83.47%when the peripheral blood B-lymphocyte counts was 101.28 cells/μl.Conclusion HAART can significantly increase the CD4^(+)T-lymphocyte and B-lymphocyte counts in AIDS patients,and the pre-treatment B-lymphocyte count has a significant effect on the efficacy of HAART in AIDS patients.