[1]李　雪,丁　艳,黄　玲,等.HIV/TB并发感染患者外周血 T淋巴细胞表达及与 HIV RNA载量的相关性研究[J].现代检验医学杂志,2022,37(01):88-91.[doi:10.3969/j.issn.1671-7414.2022.01.018]
　LI Xue,DING Yan,HUANG Ling,et al.Study on the Expression of T Lymphocytes in Peripheral Blood and Its Correlation with HIV RNA in HIV/TB Co-Infected Patients[J].Journal of Modern Laboratory Medicine,2022,37(01):88-91.[doi:10.3969/j.issn.1671-7414.2022.01.018]
点击复制

HIV/TB并发感染患者外周血 T淋巴细胞表达及与 HIV RNA载量的相关性研究()
分享到：

《现代检验医学杂志》[ISSN:/CN:]

卷:
第37卷
期数:
2022年01期
页码:
88-91
栏目:
论　著
出版日期:
2022-01-15

文章信息/Info

Title:
Study on the Expression of T Lymphocytes in Peripheral Blood and Its Correlation with HIV RNA in HIV/TB Co-Infected Patients
文章编号:
1671-7414（2022）01-088-05
作者:
李　雪1; 丁　艳1; 黄　玲1; 严加来2
（1. 南京中医药大学附属南京医院& 南京市第二医院检验科，南京市公共卫生医疗中心，南京 210003；2. 安徽医学高等专科学校医学技术系，合肥 230601）
Author(s):
LI Xue1;  DING Yan1;  HUANG Ling1;  YAN Jia-lai2
（1. Department of Clinical Laboratory, Affiliated Nanjing Hospital of Nanjing University of Traditional ChineseMedicine &Nanjing Second Hospital, Nanjing Public Health Medical Center, Nanjing 210003, China; 2. Department ofLaboratory Medicine, Anhui Medical College, Hefei 230601, China）
关键词:
人类免疫缺陷病毒; 结核; 并发感染; T淋巴细胞; 艾滋病病毒载量
分类号:
R512.91；R52；R392.11
DOI:
10.3969/j.issn.1671-7414.2022.01.018
文献标志码:
A
摘要:
目的　探讨人类免疫缺陷病毒 /结核病（ human immunide.ciency virus/tuberculosis，HIV/TB）并发感染患者的外周血 T淋巴细胞亚群的表达及其与 HIV RNA载量的相关性。方法　选取 2018年 6月～ 2020年 6月在南京市公共卫生医疗中心就诊的 HIV/TB并发感染患者 38例作为 HIV/TB组，另选取单纯人类免疫缺陷病毒 /获得性免疫缺陷综合征（human immunode.ciency virus/acquired immune de.ciency syndrome，HIV/AIDS）39例作为 HIV组，单纯 TB患者 35例作为 TB组，体检健康者 35例作为健康对照组。流式细胞术检测各组 CD3+，CD4+，CD8+ T细胞计数和 CD4+/CD8+比值；荧光定量 PCR检测 HIV RNA载量。采用 SPSS17.0统计学软件进行统计分析，并进行 Spearman相关系数分析。结果　CD3+，CD4+和 CD8+ T细胞数， CD4+/CD8+比值在各组中的差异均具有统计学意义（ H=40.758，104.279，9.637和 101.770，均 P＜ 0.05），组间两两比较结果表明，与健康对照组相比， TB组 CD3+和 CD8+T细胞数明显降低，差异均有统计学意义（ Z=-2.520，-2.972，P=0.012，0.003）；HIV组和 HIV/TB组 CD3+，CD4+ T细胞数以及 CD4+/CD8+比值均明显降低（ Z=-7.391~-4.325，均 P=0.000）。与 TB组相比， HIV组 CD3+， CD4+ T细胞数和 CD4+/CD8+比值均明显降低，差异均有统计学意义（ Z=-2.138，-7.032和 -7.380，P=0.032，0000和 0.003），但 CD8+ T细胞数明显升高（Z=-2.463，P=0.014）；而 HIV/TB组 CD3+和 CD4+ T细胞数以及 CD4+/CD8+比值均明显降低，差异均有统计学意义（Z=-3.865，-6.907和 -6.759，均 P=0.000）。与 HIV组相比， HIV/TB组的各项流式指标及 HIV RNA载量差异均无统计学意义（均 P >0.05）。HIV RNA载量与 CD3+，CD4+，CD8+ T细胞数以及 CD4+/CD8+比值均呈显著负相关（ r分别为 -0.327，-0.370，-0.296和 -0.327，均 P <0.05）。结论　HIV/TB并发感染患者外周血 CD3+，CD4+ T细胞数和 CD4+/CD8+比值均明显降低。无论有无并发 TB感染，HIV感染者的细胞免疫功能均随着病毒载量的升高而显著降低。
Abstract:
Objective　To explore the expression of T lymphocytes in peripheral blood and its correlation with HIV RNA load inHIV/TB co-infected patients. Methods　Totally 38 HIV/TB co-infected patients treated in Nanjing Public Health Medical Centerfrom June 2018 to June 2020 were selected as the HIV/TB group. Another 39 HIV/AIDS patients, 35 TB patients and 35 cases ofhealthy people in the same period were randomly selected as control groups. Flow cytometry was used to detect CD3+, CD4+,CD8+ T cell count and CD4+/CD8+ ratio in each group. Fluorescent PCR quantitative method was used to detect the HIV RNAload. Statistical analysis was carried out by using SPSS17.0 statistical software, and Spearman correlation coefficient wasanalyzed. Results　There were significant differences in CD3+, CD4+ and CD8+ T cell count and the ratio of CD4+/CD8+ in eachgroup (H = 40.758,104.279,9.637 and 101.770, all P < 0.05). Further pairwise comparison showed that CD3+ and CD8+T cellcount in the TB group were significantly decreased than that in the healthy control group, the differences were statisticallysignificant (Z=-2.520, -2.972, P=0.012，0.003). CD3+, CD4+ T cell count and the ratio of CD4+/CD8+ were significantlydecreased in HIV group and HIV/TB group, the differences were statistically significant (Z=-7.391~ -4.325, all P=0.000).Compared with TB group, CD3+, CD4+ T cell count and the ratio of CD4+/CD8+ were significantly decreased, the differences werestatistically significant(Z= -2.138, -7.032, -7.380, P=0.032，0.000，0.003), but CD8+ T cell count was significantly increased inHIV group (Z= -2.463, P=0.014). However, CD3+ and CD4+ T cell count and the ratio of CD4+/CD8+ decreased significantly inHIV/TB group, the differences were statistically significant(Z=-3.865, -6.907, -6.759, all P=0.000). Compared with the HIVgroup, there was no statistically significant differences in flow parameters and HIV RNA load in HIV/TB group (all P>0.05).CD3+, CD4+, CD8+ cell count and the ratio of CD4+/CD8+ were negatively correlated with HIV RNA (r= -0.327, -0.370, -0.296and -0.327, all P< 0.05). Conclusion　CD3+ and CD4+ T cell count and the ratio of CD4+/CD8+ were significantly decreased inHIV/TB co-infected patients. The cellular immune function of HIV patients was significantly decreased with the increase of HIVRNA copies, whether or not they were co-infected with TB.

参考文献/References:

[1] MAHY M, MARSH K, SABIN K, et al. HIV estimatesthrough 2018: data for decision-making[J]. AIDS(London, England), 2019, 33(Suppl 3): S203-S211.
[2] 陈启, 窦红勇.40 例艾滋病合并结核病患者的临床实验室特点[J]. 中华传染病杂志,2016, 34(10): 613-614.CHEN Qi, DOU Hongyong. Clinical laboratorycharacteristics of 40 AIDS patients with tuberculosis[J].Chinese Journal of Infectious Diseases,2016, 34(10):613-614.
[3] 潘克女, 张永乐, 郁文燕, 等.HIV 感染者外周血单个核细胞中HIVDNA 载量与HIVRNA 及CD4+T 淋巴细胞间的关系[J]. 中国艾滋病性病, 2020, 26(3):231-233.PAN Kenü, ZHANG Yongle, YU Wenyan, et al.Relationship between CD4+ T cell, HIV DNA and HIVRNA in PBMCs of HIV-infected patients[J]. ChineseJournal of AIDS & STD, 2020, 26(3): 231-233.
[4] 李明瑛，王和林，丁卫民．艾滋病合并肺结核的临床特点分析[J]．中国医刊,2019, 37(7): 723-726.LI Mingying, WANG Hel in, DING Weimin.Retrospective analysis of clinical features oftuberculosis and AIDS complicated with pulmonarytuberculosis [J]. Chinese Journal of Medicine,2019,37(7): 723-726.
[5] 金玮韵, 何太雯, 李骏. 男性HIV/AIDS 患者中HIV病毒载量、CD4+T 淋巴细胞数目与CMV 感染的相关性[J]．中国实验诊断学, 2020, 24(3): 415-417.JIN Weiyun, HE Taiwen, LI Jun. Correlation betweenCD4+T lymphocytes counts, HIV RNA and CMVinfection in male HIV/ AIDS patients[J]. ChineseJournal of Laboratory Diagnosis, 2020, 24(3): 415-417.
[6] SAEIDI A, CHONG Y K, YONG Y K, et al. Concurrentloss of co-stimulatory molecules and functionalcytokine secretion attributes leads to proliferativesenescence of CD8+ T cells in HIV/TB co-infection[J].Cellular Immunology, 2015, 297(1): 19-32.
[7] AMELIO P, PORTEVIN D, HELLA J, et al. HIVinfection functionally impairs Mycobacteriumtuberculosis-Specific CD4 and CD8 T-cell responses[J].Journal of Virology, 2019, 93(5): e01728-18.
[8] YIN Yongmei, QIN Jie, DAI Yaping, et al. The CD4+/CD8+ ratio in pulmonary tuberculosis: systematicand meta-analysis article[J]. Iranian Journal of PublicHealth, 2015, 44(2): 185-193.
[9] 谭清, 周仲辉, 严冬梅, 等. 成年人类免疫缺陷病毒感染者/ 艾滋病患者长期抗病毒治疗后免疫功能重建分析[J]. 中国全科医学, 2020, 23(23): 2918-2922.TAN Qing, ZHOU Zhonghui, YAN Dongmei, et al.Immune reconstitution in adult HIV/AIDS patients afterlong-term antiretroviral therapy [J]. Chinese GeneralPractice, 2020, 23(23): 2918-2922.
[10] 中华医学会感染病学分会艾滋病丙型肝炎组，中国疾病预防控制中心. 中国艾滋病诊疗指南(2018 版)[J]. 协和医学杂志,2019,10(1):41-61.AIDS and Hepatitis C Professional Group, Societyof Infectious Diseases, Chinese Medical Association;Chinese Center for Disease Control and Prevention.Chinese guidelines for diagnosis and treatment of HIV/AIDS (2018) [J]. Medical Journal of Peking UnionMedical College Hospital, 2019,10(1):41-61.
[11] 杜秀华. 艾滋病合并结核病患者与T 淋巴细胞之间的关系探究[J]. 中外医疗, 2019,38(7):10-12.DU Xiuhua. The relationship between AIDS patientswith tuberculosis and T lymphocytes [J]. China ForeignMedical Treatment, 2019,38(7):10-12.
[12] 樊萍．探讨艾滋病合并结核病患者与T 淋巴细胞之间的关系[J]．昆明医科大学学报, 2015,36(7):166-169.FAN Ping. Exploration of the relationship betweenAIDS combined with TB and T lymphocytes[J]. Journal of Kunming Medical University,2015,36(7):166-169.
[13] WOLDAY D, KEBEDE Y, LEGESSE D, et al. Roleof CD4/CD8 ratio on the incidence of tuberculosis inHIV-infected patients on antiretroviral therapy followedup for more than a decade[J]. PLoS One, 2020, 15(5):e0233049.
[14] 杨玉婷, 周芬, 华彦珺, 等. 肺结核患者外周血CD4+ T细胞的表达和相关因素Logistic 回归评估[J]．现代检验医学杂志,2016,31(2):90-93.YANG Yuting, ZHOU Fen, HUA Yanjun, et al.Expression of CD4+T cells in peripheral blood ofpatients with pulmonary tuberculosis and the assessmentof related factors by logistic regression [J]. Journal ofModern Laboratory Medicine, 2016,31(2):90-93.
[15] HUSSAIN T, KULSHRESHTHA K K, YADAV V S,et al. CD4+, CD8+, CD3+ cell counts and CD4+/CD8+ratio among patients with mycobacterial diseases(leprosy, tuberculosis), HIV infections, and normalhealthy adults: a comparative analysis of studies indifferent regions of India[J]. Journal of Immunoassay &Immunochemistry, 2015, 36(4): 420-443.
[16] SONG T, LI L J, LIU J L, et al. Study on therelationship between changes of immune cells andTNF-α in peripheral blood of patients with multidrugresistantand extensively drug-resistant tuberculosis[J].European Review for Medical and PharmacologicalSciences, 2018, 22(4): 1061-1065.
[17] LI Kui, RAN Renyu, JIANG Zicheng, et al. Changesin T-lymphocyte subsets and risk factors in humanimmunodeficiency virus-negative patients with activetuberculosis[J]. Infection, 2020, 48(4): 585-595.
[18] ELLIS P K, MARTIN W J, DODD P J. CD4 count andtuberculosis risk in HIV-positive adults not on ART: asystematic review and meta-analysis[J]. Peer J, 2017,5(12): e4165.
[19] 聂静敏, 钱娟, 何雪姣, 等. 艾滋病合并结核病对CD4+/CD8+ 比值的影响[J]. 中华医院感染学杂志,2020，30(17):2615-2619.NIE Jingmin, QIAN Juan, HE Xuejiao, et al.Impactof AIDS combined with tuberculosis on CD4+/CD8+ratio[J]. Chinese Journal of Nosocomiology, 2020，30(17):2615-2619.
[20] 张辉, 文道琛, 严兵. 艾滋病和结核病双重感染的研究进展[J]. 世界最新医学信息文摘( 连续型电子期刊) , 2019, 19(96): 107-108,110.ZHANG Hui, WEN Daochen, YAN Bing. Advancesin research on double infection of AIDS andtuberculosis[J]. World Latest Medicine Information,2019, 19(96): 107-108, 110.

相似文献/References:

[1]任 强,常文辉,张梦妍,等.2009～2014年陕西省艾滋病哨点监测重点人群HIV感染和新发感染检测分析[J].现代检验医学杂志,2015,30(03):56.[doi:10.3969/j.issn.1671-7414.2015.03.016]
　REN Qiang,CHANG Wen-hui,ZHANG Meng-yan,et al.Analysis of HIV Infection and New Infections Detection of AIDS Sentinel Surveillance Focus Groups in Shaanxi Province 2009～2014[J].Journal of Modern Laboratory Medicine,2015,30(01):56.[doi:10.3969/j.issn.1671-7414.2015.03.016]
[2]周林颖,刘 兴,伍 勇,等.HIV/AIDS 患者并发EBV 和HCMV 感染临床免疫学特征及影响因素分析[J].现代检验医学杂志,2024,39(02):91.[doi:10.3969/j.issn.1671-7414.2024.02.017]
　ZHOU Linying,LIU Xing,WU Yong,et al.Clinical Immunological Characteristic and Influencing Factors Analysis of HIV/AIDS Patients Infected with EBV and HCMV[J].Journal of Modern Laboratory Medicine,2024,39(01):91.[doi:10.3969/j.issn.1671-7414.2024.02.017]

备注/Memo

备注/Memo:
作者简介：李雪（1989-），女，本科，检验技师，从事临床检验工作，E-mail:15851801345@163.com。
通讯作者：严加来（1973-），男，硕士，副教授，E-mail:Yanjialai@ahyz.edu.cn。
更新日期/Last Update: 1900-01-01