抗免疫治疗对艾滋病合并肺结核患者脂代谢及血清CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平的影响

Effect of Anti-immune Therapy on Lipid Metabolism and Serum CD4^(+),CD8^(+),CD4^(+)/CD8^(+) Levels in AIDS Patients with Pulmonary Tuberculosis

目的探讨抗免疫治疗对艾滋病合并肺结核患者脂代谢及血清CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平的影响。方法方便选取2018年5月—2020年10月河池市宜州区人民医院感染性疾病科收治的40例艾滋病合并肺结核患者为研究对象,使用简单随机抽样的方法将患者分为对照组(20例)和观察组(20例)。两组均接受常规抗病毒、抗结核治疗,对照组在常规治疗基础上联合高效抗逆转录病毒治疗,观察组以对照组为基础,接受胸腺五肽治疗,两组均持续接受治疗6个月。比较两组治疗后临床疗效,治疗前后脂代谢、T淋巴细胞亚群水平。结果治疗后,对照组临床总有效率(65.00%)低于观察组(95.00%),两组比较差异有统计学意义(χ^(2)=3.906,P<0.05)。与治疗前比,治疗后两组血清TC、TG水平升高,且观察组更低;血清HDL-C水平降低,且观察组更高;血清CD8^(+)水平降低,且观察组更低;血清CD4^(+)水平、CD4^(+)/CD8^(+)比值升高,且观察组更高,差异有统计学意义(P<0.05)。结论胸腺五肽联合高效抗逆转录病毒治疗可有效增强艾滋病合并肺结核患者机体免疫力,提高治疗效果,同时对脂代谢水平影响较小。

Objective To explore the effect of anti-immune therapy on lipid metabolism and serum CD4^(+),CD8^(+),CD4^(+)/CD8^(+) levels in AIDS patients with pulmonary tuberculosis.Methods From May 2018 to October 2020,40 patients with AIDS complicated with pulmonary tuberculosis treated in the infectious disease department of Yizhou District People's Hospital of Hechi city were conveniently selected as the subjects.The patients were divided into control group(20 cases)and observation group(20 cases)by simple random sampling method.Both groups received conventional anti-viral and anti-tuberculosis treatment.The control group was combined with high-efficiency antiretroviral therapy on the basis of conventional treatment,and the observation group was treated with thymopentin on the basis of the control group.Both groups continued to receive treatment for 6 months.The clinical efficacy,lipid metabolism and T lymphocyte subgroup levels before and after treatment were compared between the two groups.Results After treatment,the total clinical effective rate of the control group(65.00%)was lower than that of the observation group(95.00%),the difference between the two groups was statistically significant(χ^(2)=3.906,P<0.05).Compared with before treatment,the serum TC and TG levels of the two groups increased after treatment,and the observation group was lower;and the serum HDL-C level decreased,and the observation group was higher;serum CD8^(+) levels decreased,and the observation group was even lower;serum CD4^(+) level and CD4^(+)/CD8^(+) ratio increased,and the observation group was higher,the difference was statistically significant(P<0.05).Conclusion Thymopentin combined with high-efficiency antiretroviral therapy can effectively enhance the immunity of patients with AIDS and tuberculosis,improve the therapeutic effect,and at the same time have a small effect on the level of lipid metabolism.