获得性免疫缺陷综合征合并巨细胞病毒视网膜炎患者临床实验室常规检测指标相关性分析

A Correlation Analysis of Routine Clinical Laboratory Indicators in AIDS Patients withCytomegalovirus Retinitis

目的分析合并巨细胞病毒性视网膜炎(CMVR)与非巨细胞病毒性视网膜炎(nonCMVR)AIDS患者的一般临床检测指标的差异和相关性,为CMVR患者的早期、及时诊断与治疗提供帮助。方法回顾性分析就诊于首都医科大学附属北京佑安医院33例AIDS合并视网膜病变患者入院时的一般资料和常规临床检测指标,依据房水中CMV病毒载量检测(AH-CMV)结果分为CMVR(n=20,≥500 copies/mL)和nonCMVR组(n=13,<500 copies/mL),对比分析两组T淋巴细胞、血常规检测指标之间的差异,以及各检测指标与AH-CMV的相关性。结果CMVR和nonCMVR两组患者的年龄、性别组成差异均无统计学意义;对T淋巴细胞常规检测分析显示,两组之间CD3^(+)、CD4^(+)、CD8^(+)T淋巴细胞的比例和数量差异均无统计学意义,CD4/8比值在两组之间差异无统计学意义(P>0.05);CMVR组患者中CD4^(+)T<100个/μL的患者15例(75.0%),多于nonCMVR组中CD4^(+)T<100个/μL的患者8例(61.5%),但差异无统计学意义(P>0.05);对血常规检测分析显示,两组之间WBC、LYM、MON、PLT检测值差异均无统计学意义,CMVR组患者的NEU、NLR水平显著低于nonCMVR组患者(P<0.05);AH-CMV与临床常规检测指标的相关性分析显示,AH-CMV与外周血CMV病毒载量、T淋巴细胞、WBC、NEU、LYM、MON、PLT之间均无显著的相关性,AH-CMV与NLR具有显著的负相关(P<0.05),相关系数为-0.36(95%CI:-0.68~-0.02),NLR与CD3、CD8T细胞具有显著的负相关(P<0.01),相关系数分别为-0.45(95%CI:-0.73~-0.17)、-0.46(95%CI:-0.72~-0.20)。结论CMVR与nonCMVR患者均处于免疫抑制状态,NLR比值在一定程度上反映了房水中CMV病毒载量的水平,可以为AIDS患者CMVR的诊断与治疗提供简便、可靠的临床常规检测指标。

Objective To analyze the difference and correlation of general clinical detection indexes between CMVR and non-CMVR AIDS patients,and to provide useful information for the early and timely diagnosis and treatment of CMVR patients.Methods A retrospective analysis was performed on the general data and routine clinical laboratory indicators of 33 patients with AIDS retinopathy admitted to Beijing Youan Hospital.According to the results of aqueous solution CMV viral load(AH-CMV),these patients were divided into the CMVR(n=20,≥500copies/mL)and non-CMVR group(n=13,<500copies/mL).The differences and correlation of T lymphocyte and blood routine indicators between the two groups were analyzed.Results There was no significant differences in age and gender between the CMVR and non-CMVR groups.No significant differences were observed in the proportion and number of CD3^(+),CD4^(+)and CD8^(+)T lymphocytes,also in CD4/8 ratio(P>0.05).In the CMVR group,fifteen patients(75.0%)were with CD4^(+)T<100/μL and 8 patients(61.5%)in the non-CMVR group,but with no significant difference(P>0.05).The analysis of routine blood test indicators showed no significant difference in WBC,LYM,MON and PLT between the two groups.NEU and NLR levels in CMVR were significantly lower than those in the non-CMVR group(P<0.05).The correlation analysis showed no significant correlation between AH-CMV and clinical routine indicators,such as T lymphocytes,WBC,NEU,LYM,MON and PLT.AH-CMV had a significant negative correlation with NLR(P<0.05).The correlation coefficient was-0.36(95%CI:-0.68,-0.02).NLR was significantly negatively correlated with CD3^(+)and CD8^(+)T cells(P<0.01),with the correlation coefficients being-0.45(95%CI:-0.73,-0.17)and-0.46(95%CI:-0.72,-0.20),respectively.Conclusion Both CMVR and non-CMVR patients are immunosuppressed with low level of T lymphocytes.NLR reflects the aqueous solution CMV viral load to a certain extent,which can serve as a simple and reliable clinical routine indicator for the diagnosis and treatment of CMVR in AIDS patients.