HIV感染者肠黏膜损伤分析

Analysis of Intestinal Mucosal Injury in HIV Infected Patients

目的探究HIV感染病程中肠黏膜损伤情况。方法选择无症状HIV感染者(A组)、AIDS期患者(B组)及健康组(C组)三组人群,分别行结肠镜检、结肠黏膜组织病理学检查、杯状细胞计数、结肠上皮紧密连接蛋白Claudin-1免疫组织化学及蛋白质印迹试验。对三组人群的基本信息、肠镜结果、组织病理、杯状细胞数、紧密连接蛋白Claudin-1的免疫组化及蛋白质印迹指标的组间差异及相关性进行分析,探究HIV感染者疾病进程中肠黏膜损伤情况。结果结直肠充血、糜烂、溃疡等总患病率在A组、B组、C组分别为60.0%、80.0%、13.3%(P<0.001)。对比A组,B组炎症细胞浸润更明显,淋巴滤泡数量更多(P<0.003),A组与C组比较差异不明显(P=0.233)。杯状细胞比值C组大于A组(P=0.001),A组大于B组(P=0.008)。Claudin-1平均光密度值及灰度值结果一致,C组大于A组(P<0.001),A组大于B组(P<0.001)。CD4^(+)T细胞计数与Claudin-1在免疫组织化学(P<0.001,r=0.822)及蛋白质印迹(P<0.001,r=0.792)结果均呈正相关。病毒载量水平与Claudin-1免疫组织化学(P=0.008,r=-0.476)及蛋白质印迹(P=0.003,r=-0.525)结果均呈负相关。结论HIV感染者肠黏膜损伤随着病程进展逐渐加重,杯状细胞及Claudin-1在HIV感染者肠黏膜屏障损伤中起着重要作用。

Objective To explore the intestinal mucosal damage in the course of HIV infection.Methods Three groups of patients with early HIV infection(group A),AIDS Group(group B)and healthy control group(group C)were examined by colonoscopy,histopathological examination of colon mucosa,goblet cell count,colonic epithelium tight junction protein Claudin-1 immunohistochemistry and protein blot test.Results The total prevalence rates of colorectal congestion,erosion and ulcer in group A,group B and group C were 60.0%、80.0%and 13.3%respectively(P<0.001).Compared with group A,group B had more obvious inflammatory cell infiltration and more lymphoid follicles(P<0.03),and there was no significant difference between group A and group C(P=0.233).The goblet cell ratio in group C was higher than that in group A(P=0.001),and that in group A was higher than that in group B(P=0.008).The results of average optical density and gray value of claudin-1 were consistent,group C was higher than group A(P<0.001),and group A was higher than group B(P<0.001).CD4^(+)T cell count was positively correlated with Claudin-1 in immunohistochemistry(P<0.001,r=0.822)and western blot(P<0.001,r=0.792);The viral load level was negatively correlated with the results of Claudin-1 immunohistochemistry(P=0.008,r=-0.476)and western blot(P=0.003,r=-0.525).Conclusion The intestinal mucosal injury in HIV infected patients gradually aggravates with the progress of the disease.Goblet cells and claudin-1 play an important role in the intestinal mucosal barrier injury in HIV infected patients.