艾滋病患者外周血PD-1和OPN含量与并发血小板减少症的相关性

The correlation between peripheral blood PD-1,OPN contents and thrombocytopenia in patients with acquired immune deficiency syndrome

目的分析外周血程序性细胞死亡因子-1(PD-1)、骨桥蛋白(OPN)含量与艾滋病患者并发血小板减少症的关系。方法选择新疆维吾尔自治区第六人民医院2017年5月-2019年5月期间214例艾滋病患者,根据是否发生血小板减少症分为伴血小板减少症组(60例)和单纯艾滋病组(154例),同时对伴血小板减少症组的病情程度进行评价分级(重度组13例、中度组26例、轻度组21例);另外纳入同期健康人群100名作为健康对照组。检测并比较各组外周血PD-1、OPN含量,分析外周血PD-1、OPN含量间的相关性及其分别与血小板减少症的关系。结果 214例艾滋病患者中发生血小板减少症60例,发生率为28.04%。伴血小板减少症组外周血PD-1、OPN含量最高,后由高至低依次为单纯艾滋病组、健康对照组,组间比较差异有统计学意义(P<0.05);重度组外周血PD-1、OPN含量最高,后由高至低依次为中度组、轻度组,组间比较差异有统计学意义(P<0.05)。艾滋病患者外周血PD-1与OPN含量呈正相关(r=0.571,P<0.001);经回归分析结果显示,外周血PD-1、OPN含量是艾滋病患者并发血小板减少症的影响因素(OR>1,P<0.05);绘制ROC曲线,得到外周血PD-1、OPN含量预测艾滋病患者并发血小板减少症风险的曲线下面积(AUC)为0.947、0.904,具有较高的预测价值。结论艾滋病患者外周血PD-1、OPN之间可能相互影响、共同参与血小板减少症的发生与发展,二者含量的升高可能预示着血小板减少症高风险。

Objective To analyze the relationship between the contents of peripheral blood programmed cell death factor 1(PD-1)and osteopontin(OPN)and thrombocytopenia in patients with acquired immune deficiency syndrome(AIDS).Methods 214 AIDS patients from the Sixth People’s Hospital of Xinjiang Uygur Autonomous Region from May 2017 to May 2019 were selected,and they were divided into groups according to the occurrence of thrombocytopenia. The severity of thrombocytopenia group was evaluated and graded;100 healthy people with routine physical examination in the hospital during the same period were selected as healthy control group. The peripheral blood PD-1 and OPN contents in the groups were detected and compared. The correlation between peripheral blood PD-1 and OPN contents was analyzed,and their relationships with thrombocytopenia were analyzed. Results Among 214 AIDS patients,60 cases had thrombocytopenia,with the incidence of 28.04%. The peripheral blood PD-1 and OPN contents in thrombocytopenia group were the highest,followed by simple AIDS group and healthy control group,with significant differences between groups(P<0.05). The peripheral blood PD-1 and OPN contents in severe group were the highest,followed by moderate group and mild group,with significant differences between groups(P<0.05). The peripheral blood PD-1 had positive correlation with OPN content in AIDS patients(r=0.571,P<0.001). The results of regression analysis showed that the peripheral blood PD-1 and OPN contents were influencing factors of thrombocytopenia in patients with AIDS(OR>1,P<0.05). The ROC curve was drawn,and obtained that the areas under the curve(AUC)of the peripheral blood PD-1 and OPN content to predict the risk of AIDS patients with thrombocytopenia were 0.947 and 0.904, respectively;which had higher predictive value.Conclusions Peripheral blood PD-1 and OPN in AIDS patients might interact with each other and participate in the occurrence and development of thrombocytopenia. The increase in the content of blood PD-1 and OPN might indicate a high risk of thrombocytopenia.