艾滋病患者颅内感染部位与CD4+T淋巴细胞的关系探讨

Study of the infection site and CD4+T lymphocyte among AIDS combined with opportunistic infections of the brain

目的:分别探讨艾滋病患者合并颅内感染及其感染部位与CD4+T淋巴细胞计数的关系。方法:选取2017年1月—2022年1月于长沙市第一医院进行颅脑MRI检查的156例艾滋病患者资料,并根据有无颅内感染将患者分为有颅内感染组(n=104例)及无颅内感染组(n=52例),记录患者年龄、性别、病史、CD4+T淋巴细胞计数、是否进行高效抗逆转录病毒治疗(HARRT)以及感染部位。再将颅内感染患者根据MRI所示感染部位分为额叶、颞叶、顶叶、枕叶、基底节、小脑、脑干七组,颅内感染患者根据MRI检查结果发现,额叶部位有感染的患者55例(52.9%),颞叶26例(25.0%),枕叶35例(33.6%),顶叶20例(19.2%),基底节41例(39.4%),小脑14例(13.5%),脑干15例(14.4%)。记录其CD4+T淋巴细胞计数。结果:有颅内感染组及无颅内感染组患者的年龄及CD4+T淋巴细胞计数比较,差异有统计学意义(P<0.05)。额叶与颞叶、顶叶、枕叶、小脑及脑干CD4+T淋巴细胞计数比较,差异有统计学意义(P<0.05),但与基底节区CD4+T淋巴细胞计数比较,差异无统计学意义(P>0.05)。基底节区与颞叶、枕叶、小脑及CD4+T淋巴细胞计数比较,差异有统计学意义(P<0.05),与额叶、顶叶、脑干CD4+T淋巴细胞计数比较,差异无统计学意义(P>0.05)。结论:CD4+T淋巴细胞计数越低越容易发生颅内感染,且易发于额叶及基底节区。

Objective To evaluate the relationship of the CD4+T lymphocyte level and infection site among AIDS combined with opportunistic infections of the brain.Methods The data of 156 patients with AIDS who underwent brain MRI examination in the First Hospital of Changsha from January 2017 to January 2022 were retrospectively analyzed.The patients were divided into the intracranial infection group(n=104 cases)and the non intracranial infection group(n=52 cases)according to whether there was intracranial infection,and the patient’s age,sex,medical history,CD4+T lymphocyte count,whether to carry out highly active anti-retroviral therapy(HAART)and infection site were recorded.According to the MRI findings,patients with intracranial infection were divided into seven groups:frontal lobe,temporal lobe,parietal lobe,occipital lobe,basal ganglia,cerebellum,and brainstem.According to the MRI findings,55 patients with intracranial infection at frontal lobe(52.9%),26 patients with temporal lobe(25.0%),35 patients with occipital lobe(33.6%),20 patients with parietal lobe(19.2%),41 patients with basal ganglia(39.4%),14 patients with cerebellum(13.5%),and 15 patients with brainstem(14.4%).The CD4+T lymphocyte count was recorded.Results By the single factor analysis of variance,we found that the difference of the frontal and temporal lobe,parietal lobe,occipital lobe,cerebellum and brain stem CD4+T lymphocyte count all statistical(P<0.05),but not with basal ganglia(P>0.05).And the difference of basal ganglia and temporal lobe,occipital lobe,cerebellum,and CD4+T lymphocyte count all statistical(P<0.05),but not with frontal,parietal lobe and brain stem(P>0.05).No significant differences between other groups(P>0.05).Conclusions The lower CD4+T lymphocyte level,the more prone to intracranial infection,and occurs in the frontal lobe and basal ganglia region.