平均红细胞体积在HIV感染者高效抗反转录病毒治疗疗效评价中的应用

The application value of MCV in evaluating the efficacy of HAART treatment for HIV patients

目的评价平均红细胞体积（MCV）及其变化值在川V患者高效抗反转录病毒疗法（HAART）治疗中临床价值。方法收集抗病毒治疗HIV感染者82例两次（间隔1年）MCV、CD4T细胞数值;根据是否为首次抗病毒治疗分为首次治疗组和非首次治疗组。分析比较△MCV与△CD4T淋巴细胞,组内进行Pearson相关分析。其中首次治疗42例,根据治疗时间分为治疗前组和治疗后组（即治疗1年后组）,分析比较两组外周血MCV差异。绘制ROC曲线以评价△MCV指示HIV HAART治疗是否有效及其最佳临界值。结果首次治疗组和非首次治疗组,组内△MCV和△CD4T细胞存在正相关（r值分别为0.664、0.493,P【0.01）。首次HAART治疗HIV患者,治疗前和治疗后MCV为86.8±6.2、104.2±9.4,健康对照组为88.8±3.2,三组间差异有统计学意义（F值为96.5,P【0.05）,首次HAART疗效判断中,当△MCV的临界值取12.5时,敏感度和特异度分别为82.9%、85.7%。结论 HIV患者HAART治疗时MCV存在相应变化,△MCV同△CD4T细胞存在一定相关性,△MCV判断患者HAART疗效有一定临床价值。

Objective To evaluate the clinical value of mean corpuscular volume（MCV） and it change in the treatment of HIV patients with highly active anti-retroviral therapy（HAART）.Methods Follow up and analyze the absolute value of MCV and CD4 cells of 82 HIV outpatients receiving HAART with an interval of 1 year.According to whether they’ve received antiviral treatment before,the patients were divided into two groups;first-time treatment group（FTTG） and non-first-time treatment group（NFTTG）.Use Pearson to implement correlation analysis of△MCV and△CD4in each group.Among the 82 cases 42 receive the treatment for the first time.The cases were divided into before-treatment group and after-treatment group according to the time of treatment.The differences of MCV between the two groups were compared.Draw ROC curve to evaluate the effectiveness and optimal threshold of△MCV when they indicatively predicate HIV HAART.Results In both FTTG and NFTTG,there is a positive correlation between△MCV and△CD4T cell（r values are 0.664 and 0.493 respectively,P<0.01）.MCV of FTTG was 86.8±6.2 before treatment and 104.2±9.4 after treatment,and in healthy control group 88.8±3.2.Differences among the three groups have statistical significance（F values were 96.5,P<0.05）.In the first HAART efficacy diagnosis,when the critical value of A MCV took 12.5,the sensitivity and the specificity were 82.9%and 85.7%.Conclusion The MCV of HIV patients will change after they receive HAART.△MCV has a certain correlation with△CD4T cell,which has some clinical value in predicting HAART efficacy.