160例成人HIV感染者/AIDS患者机会性感染与CD_4^+之间关系分析

目的 分析中国成人艾滋病病毒 (HIV)感染者 /艾滋病 (AIDS)患者机会性感染发生的频率与CD+4 细胞数之间的关系。方法 对 1990～ 2 0 0 1在北京佑安医院就诊的 160例成人HIV感染者 /AIDS患者CD+4 、CD+8进行跟踪分析。结果 ( 1)CD+4 >5 0 0个 / μl 66人次 ( 12 7% ) ,CD+4 为 2 0 0个 / μl～ 5 0 0个 / μl 2 12人次 ( 41 1% ) ,CD+4 <2 0 0个 / μl 2 3 4人次 ( 45 3 % )。在CD+4 <个 2 0 0 / μl中 ,CD+4 <10 0个 / μl 12 8人次 ( 2 4 8% ) ,CD+4 <5 0个 / μl 89人次( 17 2 % )。 ( 2 )CD+4 >2 0 0个 / μl时 ,共发生机会性感染 3 3人次 ( 15 6% )。CD+4 <2 0 0个 / μl时 ,共发生机会性感染170人次 ( 72 6% ) ,CD+4 为 10 0个 / μl～ 2 0 0个 / μl之间发生机会性感染 42人次 ( 3 9 6% ) ,CD+4 <10 0个 / μl发生机会性感染 12 8人次 ( 98 4% ) ,其中CD+4 <5 0个 / μl发生机会性感染 87人次 ( 97 8% )。 结论 中国成人HIV感染者 /AIDS患者在CD+4 >2 0 0个 / μl时机会性感染出现频率较少 ,CD+4 <2 0 0个 / μl时机会性感染的频率明显增加 ;CD+4 <10 0个 / μl和 <5 0个 / μl时 ,感染率约为 10 0 %。

中国HIV/AIDS患者CD_4^+CD_8^+T淋巴细胞与外周血各组份间关系的研究

目的 研究艾滋病病毒 /艾滋病 (HIV/AIDS)患者CD+ 4 、CD+ 8T淋巴细胞数与外周血各组份间白细胞(WBC)、血小板 (PLT)、血红蛋白 (HGB)、粒细胞百分数 (GR % )、淋巴细胞百分数 (LY % )、LY的相关性 ,为临床治疗提供参考依据。方法 HIV/AIDS患者抗凝外周血 5 13份 ,在 6小时之内检测其血细胞分类和CD+ 4 、CD+ 8T淋巴细胞计数 ,比较CD+ 4 、CD+ 8T淋巴细胞计数与WBC、HGB、PLT、LY %、GR %和LY的相关性。结果 CD4/CD8全部倒置 ,其中CD4/CD8<1者达 94 7% ;CD+ 4 细胞数 <5 0 0 /mm3 与HGB (r=0 16 0 ,P <0 0 1)、PLT (r=- 0 0 14 ,P <0 0 1)、GR % (r=- 0 2 81,P<0 0 1)、LY % (r =0 32 1,P <0 0 1)、LY((r =0 4 94 ,P <0 0 1)相关均有非常显著的统计学意义 ;CD+ 8细胞数与WBC数 (r=0 112 ,P <0 0 5 )、HGB (r=0 131,P <0 0 1) 、GR % (r=- 0 5 2 6 ,P <0 0 1)、LY % (r=0 5 6 9,P <0 0 1)、LY (r=0 90 4 ,P <0 0 1) 相关均有显著性 ;2 0 0 /mm3 <CD+ 4 细胞数 <5 0 0 /mm3 与LY (r=0 2 79,P <0 0 1)、PLT (r=0 192 ,P <0 0 1) 相关有显著性 ,CD+ 4 细胞数 <2 0 0 /mm3 与LY (r =0 2 6 2 ,P<0 0 1)、LY % (r =0 2 79,P<0 0 1)、GR % (r =- 0 2 94 ,P<0 0 1)

HIV感染者病毒载量和CD_4淋巴细胞计数的意义

[目的 ] 探讨人类免疫缺陷病毒 (HIV)病毒载量和CD4 淋巴细胞计数作为HIV感染者病情演变指征的意义。[方法 ] 对上海地区HIV感染者定期随访HIV病毒载量和CD4 淋巴细胞计数的变化 ,分别采用bDNA和流式细胞仪进行检测 ,所有数据均在计算机上采用SPSS软件统计分析两种指标的趋势和相关性。 [结果 ] 检测 2 82份标本 ,血浆病毒载量界于 <10 2 至 >5× 10 5拷贝数 /mL ,CD4 淋巴细胞计数 8～ 5 0 0个 /mm3;病毒载量和淋巴细胞两者存在明显的相关性 ,呈负相关趋势。 [结论 ] HIV病毒载量和CD4 淋巴细胞不仅具有明显的相关性 ,而且完全可作为HIV感染者有效的观察疾病演变的指标 。

广西壮族自治区健康成年人T淋巴细胞亚群分类绝对计数及CD_4/CD_8比值调查

目的 初步建立广西壮族自治区健康人群外周静脉血CD3 、CD4、CD8T淋巴细胞绝对数值和CD4/CD8比值的参考范围。方法 用流式细胞仪 (FACSCalibur,FCS)、三色免疫荧光试剂和绝对计数管 (TnTEST/Tru COUNT) ,检测 110名广西健康成年人 (16～ 5 6岁 )静脉全血CD3 、CD4、CD8T淋巴细胞绝对数值和CD4/CD8比值 ,并观察T淋巴细胞亚群分类计数在性别、年龄和民族上的差别。结果 110名健康成年人检测结果平均值 :CD3 为5 2 4± 5 4 1,CD4为 82 3± 30 5 ,CD8为 6 0 1± 2 4 8,CD4/CD8为 1 4 9± 0 5 3。进一步分析发现 ,CD4和CD4/CD8在民族分布上 (汉族 79名、壮族 31名 )的差异有显著的统计学意义 (P <0 0 5 )。结论 这次初步建立CD3 、CD4、CD8T细胞绝对数值和CD4/CD8比值正常参考范围 ,对于指导广西的艾滋病诊断及治疗工作有重要意义。

冠心宁片联合重组人脑利钠肽治疗腹膜透析合并急性失代偿性心力衰竭的疗效观察及其对免疫功能、炎症状态的影响

目的:观察冠心宁片联合重组人脑利钠肽(rhBNP)治疗腹膜透析(PD)合并急性失代偿性心力衰竭(ADHF)的临床疗效及其对免疫功能和炎症状态的调节作用。方法:将78例PD合并ADHF患者随机分成观察组和对照组,各39例,对照组给予rhBNP微泵注射,治疗72 h后停药;观察组在对照组基础上给予冠心宁片,2组患者均治疗4周。比较2组临床疗效及治疗前后症状评分、心功能指标、炎性细胞因子水平、CD_(4)^(+)T淋巴细胞亚群及不良反应和预后等。结果:观察组临床总有效率(94.87%)高于对照组(79.48%)(P<0.05);治疗后两组患者胸闷胸痛、心悸不安、气短乏力、气喘不得卧等症状评分均较治疗前降低(均P<0.05),且观察组低于对照组(P<0.05);治疗后两组患者左室射血分数(LVEF)、左心室短轴缩短率(LVFS)、心脏指数(CI)、白细胞介素-10(IL-10)和2型辅助性T细胞(Th2)、调节性T细胞(Treg)水平较治疗前升高(均P<0.05),且观察组高于对照组(P<0.05);治疗后两组患者左心室舒张末期内径(LVEDd)、干扰素-γ(INF-γ)、IL-17、Th1、Th17、Th1/Th2和Th17/Treg较治疗前降低(均P<0.05),且观察组低于对照组(P<0.05);观察组不良反应发生率和出院30 d内ADHF再入院率均降低。结论:冠心宁片联合能rhBNP明显改善PD合并ADHF患者的临床症状和心功能水平,有效调节免疫功能及缓解炎症状态,临床疗效确切。

Correlation Analysis on Total Lymphocyte Count and CD4 Count in HIV-infected Patients: A Retrospective Evaluation

CD4 count is the standard method for determining eligibility for highly active antiretroviral therapy （HAART） and monitoring HIV/AIDS disease progression, but it is not widely available in resource-limited settings. This study examined the correlation between total lymphocyte count （TLC） and CD4 count of HIV-infected patients before and after HAART, and assessed the thresholds of TLC for making decisions about the initiation and for monitoring HAART. A retrospective study was performed, and 665 HIV-infected patients with TLC and CD4 count from four counties （Shangcai, Queshan, Shenqiu and Weishi） were included in the study. Pearson correlation and receiver operating characteristic （ROC） were used. TLC and CD4 count after HAART was significantly increased as compared with pre-HAART （P〈0.01）. An overall positive correlation was noted between TLC and CD4 count （pre-HAART, r=0.73, P=0.0001; follow-up HAART, r=0.56, P=0.0001）. The ROC curve between TLC and CD4 count showed that TLC ≤ 1200 cells/mm3 could predict CD4 〈 200 cells/mm3 with a sensitivity of 71.12%, specificity of 66.35% at pre-HAART. After 12-month HAART, the optimum prediction for CD4 count 〈 200 cells/mm3 was a TLC ≤ 1300 cells/mm3, with a sensitivity of 63.27%, and a specificity of 74.84%. Further finding indicated that TLC change was positively correlated to CD4 change （r=0.77, P=0.0001） at the time point of 12-month treatment, and the best prediction point of TLC change for CD4 increasing was 135 cells/mm3. TLC and its change can be used as a surrogate marker for CD4 count and its change of HIV-infected individuals for making decisions about the initiation and for monitoring HAART in resource-limited settings.

Assessing the effect of traditional Chinese medicine on CD4+ lymphocyte count of 807 HIV/AIDS cases

National Free Traditional Chinese Medicine (TCM) HIV/AIDS Treatment Program had been carried out for more than 5 years, treating 9267 cases accumulately by 2009. We report the 3-year outcome on CD4+ lymphocyte count of 807 cases of HIV/AIDS enrolled in the National Free TCM HIV/AIDS Treatment Pro- gram, the CD4+ lymphocyte count were measured every 6 month at 7 time points (0, 6, 12, 18, 24, 30, 36 month). The results showed that the overall CD4+ ly mphocyte count maintained stable at the 6th month and the 12th month, declined significantly at the 18th month, 24th month and 30th month, then elevated to the pre-treatment level at the 36th month. Patients with pre-treatment CD4+ lymphocyte count level 350/mm3 had CD4+ lymphocyte count declined significantly after all visits. In summary, combined treatment of Chinese herbal medicine and conventional therapy on HIV/AIDS suggested promising effect, but more evidences from larger, rigorous designed studies still needed to support the affirmative effect of TCM in the future.

Detection of microbial antigenic components of circulating immune complexes in HIV patients:Involvement in CD4^+ T lymphocyte count depletion

Objective:To investigate the prevalence of microbial antigenic components of circulating immune complexes amongst grades of CD4 T lymphocyte counts in HIV sero positive and seronegative participants.Methods:Polyethelene glycol(PEG-600) and buffering methods of precipitation and dissociation of immune complexes was used to generate immune solution from sera of 100 HIV sero-positive and 100 HIV sero-negative participants.These were categorized into 3 grades based on CD4 count:】 500 cell/mm,200-499 cell/mm3 and 【200 cell/mm3.The immune solutions were assayed using membrane based immunoassay and antibody titration, along side its unprocessed serum for detection of various microbial antigens and or antibodies. CD4 T cell counts were estimated using Patec Cyflow SL-3 Germany.Results:Antigenic component of immune complexes of various infectious agents was detected in 99 and 70 HIV seropositive and HIV sero-negative participants,respectively.In group A,there were 10 HIV positive participants,including 4(40.0%) had circulating immune complexes(CICs) due to Salmonella species only:1(10.0%) due to Salmonella-Plasmodium falciparum(P.falciparum),SalmonellaP. falciparum-HCV and P.falciparum antigens,respectively.In group B,45(45.4%) HIV seropositive participants with CICs had CD4 T lymphocyte count between 200-499 cells/mm^3.Out of these,20(44.4%) had CICs due to Salmonella species only:9(20%) due to Salmonella-P. falciparum.In group C,there were 44(44.4%) HIV sero-positive participants,including 3(6.8%) due to Salmonella species only:24(54.4%) due to Salmonella-P.falciparum:2(4.5%) due to P. falciparum only.Conclusions:In HIV sero-positive participants,presence of heterogeneity of Salmonella species-P.falciparum antigens was highly incriminated in CD4 count depletion but not homogeneity of malaria parasites antigens.Malaria parasites antigens only were incriminated in CD4^+ count depletion amongst HIV sero-negative participants.Before taking any decision on the management of HIV-1-positive individuals,their malaria and Salmonella paratyphi status should be assessed,but not malaria status alone.

CD4 T-Lymphocytes Count in HIV-<i>Toxoplasma gondii</i>Co-Infected Pregnant Women Undergoing a Prevention of Mother-to-Child Transmission Program

Toxoplasma gondii (T. gondii) is a parasite responsible of toxoplasmosis, a disease often asymptomatic but with serious consequences in pregnant women and immunocompromised subjects. Objective: This study aimed to investigate the impact of T. gondii infection on CD4+ T lymphocytes count in HIV-infected pregnant women. Methods: This was a cross-sectional study of pregnant women co-infected by HIV and T. gondii. The study was conducted from January to July 2016 at the Prevention of Mother-to-Child Transmission of HIV (PMTCT) sites in the Health District of Lacs in Togo. Diagnosis of HIV was performed by immuno-chromatographic methods with Determine TM HIV-1/2 and immuno-filtration with Tri-Dot HIV-1 and 2 kits. Presence of anti-toxoplasmic IgG and IgM antibodies was established via enzyme immunoassay using ELISA-BIOREX&reg;kit. Flow cytometry was used to count CD4+ T lymphocytes. Results: Our study found that of the 4599 pregnant women, 111 (2.41%) were HIV-positive. Among them, 109 (98.20%) were infected by HIV-1 and 2 (1.98%) by HIV-2. Antibodies against T. gondii were detected in 5.36% (IgM), 25% (IgG) and 3.57% (both IgM and IgG) of HIV 56 infected women. There was no significant difference between CD4 cell count in HIV (+)/T. gondii IgM (-)/IgG (-) infected pregnant women (378.8 ± 222.8 cell//μl) compared to HIV (+)/T. gondii/IgM (+) (457.3 ± 183.3 cell//μl), HIV (+)/T. gondii IgG (+) (419.4 ± 287.3 cell//μl) and HIV (+)/T. gondii IgM/IgG (+) (480.5 ± 252.4 cell/μl). Conclusion: This study showed that intracellular parasite T. gondii did not alter CD4+ T lymphocytes count in HIV/T. gondii co-infected pregnant women.

新发HIV/AIDS患者抑郁心理干预效果及其与CD_(4)^(+)T细胞计数的关系研究

背景HIV/AIDS与抑郁症相关,抑郁症加大HIV相关认知紊乱(HAND)风险,并降低患者抗逆转录病毒治疗(ART)依从性,加剧HIV传播风险。国内研究较少报道新发HIV/AIDS患者(PLWHA)抑郁心理干预效果及与CD_(4)^(+)T细胞计数相关性。目的探究新发PLWHA抑郁心理干预效果及与CD_(4)^(+)T细胞计数相关性,为AIDS临床诊疗提供参考。方法2020年4月—2022年6月采用方便取样方法在江西省ART定点医院抽取新发PLWHA抑郁患者,患者确诊后立即启动ART及心理干预,干预总周期为12周。在干预前后采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)进行评估,并检测CD_(4)^(+)T细胞计数进行分析。结果共纳入新发PLWHA抑郁患者200例,有效随访178例,有效率为89.0%。178例PLWHA抑郁患者轻中度88例(49.4%)、重度90例(50.6%),伴焦虑者173例(97.2%)。患者CD_(4)^(+)T细胞计数均值在干预前为(346.39±156.87)个/μL,干预后为(421.93±149.61)个/μL。干预后,新发PLWHA抑郁患者CD_(4)^(+)T细胞计数高于干预前(t_(配对)=10.971,P<0.05),HAMD、HAMA总分及各因子评分均低于干预前(P<0.05)。干预前,HAMD总分与CD_(4)^(+)T细胞计数分级(以500个/μL为分界值)呈负相关(r_(s)=-0.157,P=0.036)、与HAMA总分呈正相关(r_(s)=0.764,P<0.001)。干预后,HAMD总分与干预后CD_(4)^(+)T细胞计数呈负相关(r_(s)=-0.150,P=0.046)、与HAMA总分呈强正相关(r_(s)=0.939,P<0.001)。干预前,新发PLWHA抑郁患者CD_(4)^(+)T细胞计数<500个/μL者HAMD、HAMA总分高于CD_(4)^(+)T细胞计数≥500个/μL者(P<0.05)。结论新发PLWHA抑郁严重程度与CD_(4)^(+)T细胞计数相关,经专业心理干预能显著改善。

基于血清HE4、PLR、RLX、KPNA2构建晚期卵巢上皮性癌术后复发风险预测模型的临床研究

目的探讨基于血清人附睾蛋白4(HE4)、血小板计数/淋巴细胞计数比值(PLR)、血清松弛素(RLX)、核转运蛋白α2(KPNA2)构建晚期卵巢上皮性癌术后复发风险预测模型。方法选取2016年1月至2019年1月苏州市立医院(东区)诊治的124例晚期卵巢上皮性癌患者作为研究对象,根据晚期卵巢上皮性癌患者是否复发分为复发组和无复发组。HE4水平采用电化学发光免疫分析法检测,根据血常规结果计算PLR,酶联免疫吸附试验检测RLX、KPNA2水平。晚期卵巢上皮性癌患者术后复发的影响因素采用多因素Logistic回归分析,并建立晚期卵巢上皮性癌术后复发风险预测模型。采用受试者工作特征(ROC)曲线评估晚期卵巢上皮性癌术后复发风险预测模型的预测效能,利用Hosmer-Lemeshow检验分析患者晚期卵巢上皮性癌术后复发风险预测模型的拟合度。结果复发组与无复发组在肿瘤国际妇产科联盟(FIGO)分期及血清糖类抗原125、HE4、PLR、RLX、KPNA2水平比较,差异有统计学意义(P<0.05)。肿瘤FIGO分期Ⅳ期及血清HE4、PLR、RLX、KPNA2升高是晚期卵巢上皮性癌患者术后复发的危险因素(P<0.05)。ROC曲线分析显示,晚期卵巢上皮性癌术后复发风险预测模型的曲线下面积为0.859,均明显高于HE4、PLR、RLX、KPNA2单一指标检测。通过Hosmer-Lemeshow检验分析,晚期卵巢上皮性癌术后复发风险预测模型有较好的拟合度(χ^(2)=7.869,P=0.437)。结论基于血清HE4、PLR、RLX、KPNA2及肿瘤FIGO分期构建的晚期卵巢上皮性癌术后复发风险预测模型对于评估患者晚期卵巢上皮性癌术后复发具有较高的预测价值,值得临床关注。

CD_(4)^(+)T淋巴细胞穿孔素基因启动子低甲基化水平在戒烟大鼠肺气肿进展中的作用及S-腺苷甲硫氨酸的干预效果

目的探讨CD_(4)^(+)T淋巴细胞穿孔素基因启动子甲基化水平与戒烟后大鼠肺气肿持续进展的关系及S-腺苷甲硫氨酸(SAM)的干预效果。方法将20只SD大鼠随机分为4组:正常对照组、模型组、戒烟4周组、戒烟后SAM干预4周组,各5只,后3组香烟烟雾暴露法建立大鼠肺气肿模型并采取相应措施。各组取右下肺组织行苏木精-伊红(HE)染色观察病理学改变,测量平均内衬间隔(MLI)和平均肺泡数(MAN)。用免疫磁珠法从各组大鼠的脾脏中分选出CD_(4)^(+)T淋巴细胞,提取其DNA,检测CD_(4)^(+)T淋巴细胞穿孔素基因启动子区域的甲基化水平。结果模型组、戒烟4周组、戒烟后SAM干预4周组MLI均较正常对照组增加(均P<0.05),其中戒烟4周组较模型组、戒烟后SAM干预4周组增加(均P<0.05)。模型组、戒烟4周组、戒烟后SAM干预4周组MAN均较正常对照组减小(均P<0.05),其中戒烟4周组较模型组减小(P<0.05)。模型组和戒烟4周组CD_(4)^(+)T淋巴细胞穿孔素基因启动子甲基化水平均低于正常对照组和戒烟后SAM干预4周组[(93.9±3.1)%、(93.1±1.8)%比(97.1±1.1)%、(96.4±1.5)%](均P<0.05)。结论CD_(4)^(+)T淋巴细胞穿孔素基因启动子低甲基化水平在大鼠戒烟后仍持续存在,可能是戒烟后大鼠肺气肿不断恶化的原因之一;而给予SAM干预后,戒烟大鼠的肺气肿恶化可好转。

鸡外周血T淋巴细胞分群及免疫相关基因表达分析

为探索鸡抗病育种中简便实用的免疫功能测定指标,试验采用成像流式细胞术对四川山地乌骨鸡和大恒699肉鸡配套系的4周龄和10周龄外周血进行T淋巴细胞亚群分型,并检测外周血中白介素6(IL-6)、Toll样受体3(TLR3)和干扰素(IFN-γ)基因的表达水平。结果显示:10周龄时,CD_(4)^(+)T淋巴细胞亚群在两鸡种间差异显著(P<0.05),4周龄和10周龄的两鸡种CD_(8)^(+)T淋巴细胞亚群均有极显著差异(P<0.01);CD_(4)^(+)/CD_(8)^(+)比值在0.7~1.6之间呈正态分布,且随周龄增加而降低;大恒699肉鸡配套系的CD_(4)^(+)/CD_(8)^(+)比值比四川山地乌骨鸡高;IL-6和IFN-γ表达量随周龄增加而增加,但TLR3相反。细胞因子的增多和CD_(4)^(+)/CD_(8)^(+)比值的降低表明鸡只随周龄增长,机体免疫平衡发生改变。结果表明,基于成像流式细胞术进行鸡外周血T淋巴细胞分型简易可行,CD_(4)^(+)/CD_(8)^(+)比值可作为鸡免疫力检测的一个指标;天然免疫相关基因IL-6、TLR3和IFN-γ基因的表达量可以作为免疫力检测的参考。

不同预后疗效的特发性膜性肾病外周血淋巴细胞亚群变化的临床分析

目的:回顾性分析治疗前后特发性膜性肾病(IMN)患者的淋巴细胞亚群计数,初步探索不同淋巴细胞亚群在IMN患者的临床疗效和预后判断中可能的作用。方法:收集我院2019年01月-2022年03月经肾穿刺或者血清学抗磷脂酶A2受体抗体(sPLA2R-Ab)阳性诊断为IMN患者的临床资料,根据患者随访末期有无达到临床缓解,分为缓解组和未缓解组,比较两组之间基线临床指标以及随访前后淋巴细胞亚群计数的差异。并根据患者sPLA2R-Ab是否阳性分别比较淋巴细胞亚群差异。结果:两组患者基线期在性别、年龄、尿蛋白定量、血肌酐、血白蛋白水平等差异均无统计学意义(P>0.05);与缓解组相比,未缓解组表现更高的外周血CD_(4)^(+)淋巴细胞计数及CD_(4)^(+)/CD+8比值,且这种表现在随访末依旧存在(P<0.05)。根据基线sPLA2R-Ab是否阳性进行分组分析发现,两组CD_(4)^(+)计数未缓解组较缓解组均明显升高,差异具有统计学意义(P<0.05)。结论:初步临床观察表明,IMN患者外周血CD_(4)^(+)计数及CD_(4)^(+)/CD+8比值升高,提示这类患者的疗效可能不佳,详细机制有待进一步研究。

系统性红斑狼疮患者血清TNF-α表达与T淋巴细胞亚群的关系

目的探讨系统性红斑狼疮(SLE)患者血清肿瘤坏死因子⁃α(TNF⁃α)表达与T淋巴细胞亚群的关系。方法选取淮安市第一人民医院2019年1月至2022年1月收治的94例SLE患者(狼疮组)及同期年龄、性别匹配的60名健康体检者(对照组)作为研究对象,根据SLE活动性指数(SLEDAI)评分将研究组分为活动组(53例)和非活动组(41例),检测所有受试者的外周血T淋巴细胞亚群(CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+))、CD_(4)^(+)/CD_(8)^(+)及血清TNF⁃α表达水平,分析不同组别上述指标表达水平,采用Spearman相关性分析血清TNF⁃α表达水平与CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+)的相关性。结果狼疮组的CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)低于对照组,CD_(8)^(+)、TNF⁃α高于对照组,差异有统计学意义(P<0.05)。SLE患者中活动组的CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)低于非活动组,CD_(8)^(+)、TNF⁃α高于非活动组,差异有统计学意义(P<0.05)。狼疮组中血清TNF⁃α水平与CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)呈负相关,r值分别为-0.586、-0.611、-0.656(P<0.05),与CD_(8)^(+)呈正相关,r值为0.564(P<0.05)。TNF⁃α评估SLE病情严重程度曲线下面积(AUC)为0.758,最佳截点为4.35(pg/mL),此时诊断敏感度为81.13%,特异性为65.85%。结论SLE患者存在TNF⁃α及T淋巴细胞亚群表达异常,在疾病活动期患者中更为明显,且SLE患者中TNF⁃α表达水平与T淋巴细胞亚群水平关系密切,通过检测TNF⁃α水平,提示其与SLE患者的疾病活动度具有相关性。

CD_(4)^(+)与CD_(8)^(+)T淋巴细胞在骨关节炎中作用的研究进展

骨关节炎是一种慢性、进行性、破坏性的关节炎性病变,常累及软骨及周围组织,最终可导致关节衰竭并伴有疼痛和残疾。许多证据表明免疫机制贯穿骨关节炎的发生发展,目前研究发现,CD_(4)^(+)、CD_(8)^(+)T淋巴细胞介导的细胞免疫通过细胞分化、组织浸润、免疫亚群失衡以及释放不同的细胞因子,激活相关细胞通路,造成滑膜炎症、软骨丢失、降解、内稳态失衡以及软骨下骨重建等。现就CD_(4)^(+)、CD_(8)^(+)T淋巴细胞在骨关节炎中作用的研究进展进行总结。

Poor CD4 count is a predictor of untreated depression in human immunodeficiency virus-positive African-Americans

AIM: To determine if efforts to improve antiretroviral therapy(ART) adherence minimizes the negative impact of depression on human immunodeficiency virus(HIV) outcomes. METHODS: A cross-sectional study of a clinic-based cohort of 158 HIV seropositive(HIV+) African Americans screened for major depressive disorder(MDD) in 2012. CD4 T lymphocyte(CD4+) counts were obtained from these individuals. Self-report on adherence to ART was determined from questionnaire administered during clinic visits. The primary outcome measure was conditional odds of having a poorer CD4+ count(< 350 cells/mm3). Association between CD4+ count and antidepressant-treated or untreated MDD subjects was examined controlling for self-reported adherence and other potential confounders. RESULTS: Out of 147 individuals with available CD4+ T lymphocyte data, 31% had CD4+ count < 350 cells/mm^3 and 28% reported poor ART adherence. As expected the group with > 350 cells/mm^3 CD4+ T lymphocyte endorsed significantly greater ART adherence compared to the group with < 350 cells/mm3 CD4+ T lymphocyte count(P < 0.004). Prevalence of MDD was 39.5% and 66% of individuals with MDD took antidepressants. Poor CD4+ T lymphocyte count was associated with poor ART adherence and MDD. Adjusting for ART adherence, age, sex and education, which were potential confounders, the association between MDD and poor CD4+ T lymphocyte remained significant only in the untreated MDD group.CONCLUSION: Therefore, CD4+ count could be a clinical marker of untreated depression in HIV+. Also, mental health care may be relevant to primary care of HIV+ patients.

艾滋病合并肺结核治疗效果与CD_(4)^(+)T淋巴细胞及影像学的相关性

目的探究临床上艾滋病合并肺结核患者的治疗效果和CD_(4)^(+)T淋巴细胞以及影像学之间的相关性。方法在滇南中心医院2018年1月—2019年1月期间收治的艾滋病合并肺结核患者中随机选取30例作为研究组,同期单纯肺结核患者30例作为对照组,对2组患者的CD_(4)^(+)T淋巴细胞检查结果和胸部CT中所表现出的影像学特征进行对比分析。结果治疗前,研究组的CD_(4)^(+)T淋巴细胞数量低于对照组(P<0.05)。治疗后,研究组患者CD_(4)^(+)T淋巴细胞数量有所提升,对照组患者CD_(4)^(+)T淋巴细胞数量无明显变化,但研究组仍低于对照组(P<0.05)。30例AIDS合并肺结核患者中25例呈现出不典型肺结核特征,5例呈现出典型肺结核特征,在CD_(4)^(+)T淋巴细胞分布全宽方面,不典型肺结核患者主要分布于100~200个/μL的范围内,典型肺结核患者主要分布于<100个/μL的范围内。艾滋病合并肺结核患者的CT结果主要表现为不典型肺结核且具有多样性变化特点。结论艾滋病合并肺结核患者的CD_(4)^(+)T淋巴细胞数量较单纯肺结核患者低,通过系统治疗之后,CD_(4)^(+)T淋巴细胞数量显著升高,影像学检查大部分患者的临床表现为非典型肺结核疾病。

低发病率地区20例HIV/AIDS个案流行病学调查分析

目的了解低发病率地区HIV/AIDS在人群中的发病特征。方法采用河南省性病艾滋病防治研究所制订的《HIV/AIDS个案调查表》,对HIV/AIDS本人或家属进行逐项调查,并采血送省进行CD+4T淋巴细胞检测。结果(1)濮阳市HIV/AIDS流行率为0.56/10万(河南省人群估计HIV感染率约为35/10万),处于低发病率水平。(2)以性接触传播为主(50%),5例为配偶间性传播,5例有婚外性行为史。(3)HIV感染者CD+4T淋巴细胞大于300者只有3例,已陆续开始发病与死亡。结论濮阳市HIV/AIDS处于低发病率水平;以性接触传播为主;性行为传播是由高危人群向一般人群扩散的桥梁。

Haematology Parameters of Apparently Healthy Prospective Whole Blood Donors in a Nigerian Hospital Setting

Background: Adequate selection of a prospective whole blood donor protects his health and safety of the recipient. Objectives: The main objective of this study was to determine the haematology parameters of apparently healthy prospective whole blood donors. Participants and Methods: This was a hospital based prospective study carried out from August to October 2020 at the blood transfusion unit of the Lagos State University Teaching Hospital (LASUTH), Ikeja, Nigeria. A structured pretested questionnaire was used for data collection. The socio demographic status and the haematology parameters of apparently healthy prospective whole blood donors who tested negative for HIV, hepatitis B and C markers were captured. Obtained data were analysed with the statistical package for the social scientist software version 20. Results: One hundred male (97.1%) and three female (2.9%) apparently healthy prospective whole blood donors were studied. The median age of study subjects was 30 years. Obtained median haematology parameter values were 13 g/dl, 40%, 4.9/nl and 203.9/nl for haemoglobin concentration, haematocrit, total white cell and platelet counts respectively. The median values for the mean corpuscular haemoglobin concentration (MCHC), mean corpuscular haemoglobin (MCH) and mean corpuscular volume (MCV) of participants were 32.6 g/dl, 27.7 pg and 85.7 fl respectively. Observed prevalence of subnormal haematology parameters for haemoglobin concentration, total white cells, platelets were 12.6%, 25.2%, and 13.6% respectively. Also subnormal values for MCHC, MCH, MCV were 11.7%, 26.2%, and 16.5% respectively among prospective whole blood donors in this study. No higher than normal haematology parameter values were observed. Median values for erythrocyte sedimentation rate was 8.4 mm/hr. Conclusion: A significant percentage of apparently healthy prospective whole blood donors had subnormal haematology parameters values. Obtained normal values in our study are comparable with local reference range reports from previous studies in Nigeria and other parts of Africa. 124947 .