艾滋病抗病毒疗法患者CD4+ T淋巴细胞变化的相关因素研究

Dynamic variation of CD4-positive T-lymphocyte count and influencing factors in patients receiving highly-active antiretroviral therapy

摘要:

目的  探讨CD4+ T淋巴细胞在艾滋病行抗病毒疗法患者中变化的相关因素。方法  选择180例首次开始行抗病毒治疗的艾滋病患者作为研究对象。随访1年，观察患者CD4+ T淋巴细胞的变化，并根据CD4+ T淋巴细胞是否升高分为升高组与未升高组，采用回顾性方法记录相关信息，筛选出影响CD4+ T淋巴细胞升高的相关因素，采用多因素Logistic回归进行危险因素分析。结果  180例抗病毒治疗的艾滋病患者中，110例（61.1%）CD4+ T淋巴细胞升高>100个/mm3。抗病毒治疗后，两组患者CD4+ T淋巴细胞数量及人类免疫缺陷病毒（HIV）-RNA载量均明显改善，但升高组改善更明显，差异有统计学意义（P <0.05）。性别、年龄、临床分期、漏服及基线CD4+ T淋巴细胞与CD4+ T淋巴细胞升高有相关性，差异有统计学意义（P <0.05）；多因素分析显示，年龄>50岁、基线CD4+ T淋巴细胞≥200个/mm3是促进CD4+ T淋巴细胞升高的因素；年龄≤50岁、漏服及基线CD4+ T淋巴细胞<200个/mm3是CD4+ T淋巴细胞升高的危险因素（P <0.05）。结论  艾滋病患者抗病毒治疗后CD4+ T淋巴细胞数量升高，但年龄、漏服及基线CD4+ T淋巴细胞可影响其升高程度，在临床实际中需要引起重视。

Abstract:

Objective To analyze dynamic variation of CD4-positive T-lymphocyte count and influencing factors in AIDS patients receiving highly-active antiretroviral therapy. Methods One hundred and eighty patients who received antiviral treatment for the first time were selected. Their CD4-positive T-lymphocyte count at baseline and 1 year after treatment were analyzed. All patients were divided into rise group and non-rise group according to whether the CD4-positive T-lymphocyte count rose or not. The relevant factors affecting the rising of CD4-positive T-lymphocyte count were selected, and multivariate logistic regression analysis was used to analyze the risk factors. Results The CD4-positive T-lymphocyte count increased by >100 cells/mm3 in 110 of the 180 patients (61.1%) after antiviral treatment. The CD4-positive T-lymphocyte count and HIV-RNA were improved after highly-active antiretroviral therapy which was more obvious in the rise group with significant difference(P < 0.05). There were correlations between gender, age, clinical stage, missing drug and baseline CD4-positive T-lymphocytes and CD4-positive T-lymphocytes counts rising (P < 0.05). Multi-factor analysis showed that age > 50 years old and baseline CD4-positive T-lymphocyte ≥200 cells/mm3 were the protective  factors of CD4-positive T-lymphocyte count rising; and age ≤50 years old, missing drug and baseline CD4-positive T-lymphocyte <200 cells/mm3 were the risk factors of CD4-positive T-lymphocyte count rising (P < 0.05). Conclusions CD4-positive T-lymphocyte count is rising after highly-active antiretroviral therapy, which can be affected by age, missing drug and baseline CD4-positive T-lymphocytes.