可溶性白介素-2受体对艾滋病病毒感染者和(或)艾滋病患者的临床意义

Clinical significance of soluble interleukin-2 receptors determination in HIV/AIDS patients

目的 观察国人艾滋病病毒感染者和 (或 )艾滋病 (HIV/AIDS)患者及其合并丙型肝炎时血清可溶性白介素 2受体 (solubleinterleukin 2receptor,SIL 2R )水平 ,及HIV/AIDS患者血清SIL 2R与CD4 + T淋巴细胞计数的关系 ,探讨血清SIL 2R对观察HIV/AIDS患者病情进展、判断预后方面的临床意义及其合并丙型肝炎时机体的免疫激活情况。方法 收集 137例HIV/AIDS患者的血清和抗凝全血 ,用流式细胞术检测患者外周血CD4 + T淋巴细胞计数 ,用酶联免疫吸附测定法 (ELISA)检测血清SIL 2R。结果 在正常人、丙型肝炎、HIV感染及HIV感染合并丙型肝炎 4组不同人群中 ,SIL 2R值为正常人 <丙型肝炎患者 <HIV感染者 <HIV感染合并丙型肝炎者。HIV感染组较丙型肝炎组高 ,但组间差异无统计学意义 ,其余组间两两比较差异均有统计学意义。SIL 2R值为HIV感染者 <AIDS患者 ,CD4 + T淋巴细胞计数正常人 >HIV感染者 >AIDS患者 ,SIL 2R与CD4 + T淋巴细胞呈负相关 (Pearson相关系数为r =- 0 .6 5 6 ,P <0 .0 0 1)。结论 SIL 2R在HIV感染者外周血中异常增高 ,高于丙型肝炎与正常人 ,HIV感染合并丙型肝炎患者则进一步升高。SIL 2R随着HIV感染者的疾病进展而进行性增高 ,随着CD4 + T淋巴细胞下降而明显升高 ,与疾病进展及CD4 + T淋巴细胞计?

Objective The serum soluble IL-2 receptor (SIL-2R) levels were observed in HIV/AIDS patients, and HIV/AIDS patients complicated with hepatitis C. To observe the influence of CD4 +T cell counts on serum SIL-2R levels. To explore the clinical significance of SIL-2R determination in evaluation of disease condition, progression, prognosis,effect assessment and immunity activation.Methods One hundred and thirty-seven cases of HIV/AIDS patients were chosen for determination of their peripheral blood CD4 +T cell counts by flow cytometry, the serum SIL-2R levels with enzyme-linked immunosorbent assay(ELISA). Results Among normal healthy controls, HCV patients, HIV-seropositive individuals and HIV-seropositive patients complicated with hepatitis C, the serum SIL-2R levels of HIV-seropositive individuals complicated with hepatitis C were the highest, and HIV-seropositive group was higher than HCV group, but there was no difference statistically. There was difference statistically in the other two groups.The serum SIL-2R levels of AIDS patients were higher than those of asymptomatic individuals. But CD4 +T cell counts of asymptomatic patients were higher than those of AIDS patients. There was negative correlation between SIL-2R levels and CD4 +T cell counts(r= -0.656, P< 0.001).Conclusion The serum SIL-2R levels of HIV infected patients abnormally increased, are much higher than those of normal controls and patients with hepatitis C, the highest levels are in the HIV/AIDS patients complicated with hepatitis C. The levels of SIL-2R increase with disease progression and a decrease in CD4 +T cell counts. There is a negative correlation between SIL-2R levels and CD4 +T cell counts. Thus SIL-2R may be a useful marker of disease activity and progression.