摘要
目的分析HIV感染者血β2微球蛋白(β2MG)的临床意义。方法检测HIV感染者血β2MG、蛋白电泳、T淋巴细胞亚群计数、肌酐,分析血β2MG与蛋白电泳、T淋巴细胞亚群计数的相关性。结果HIV感染者血β2MG升高者占86.5%(64/74),其中无症状期、AIDS期患者中血β2MG升高者分别占90.9%(20/22)、84.6%(44/52)。AIDS期患者血β2MG水平显著高于无症状期感染者(P<0.01),且CD4<200/ml的HIV感染者血β2MG明显高于CD4>200/ml的感染者(P<0.05);78.8%(67/85)HIV感染者血清γ球蛋白百分比升高,其中无症状期和AIDS期感染者分别为75%(27/36)和81.6%(40/49)。未观察到无症状期和AIDS期感染者γ球蛋白百分比有统计学差异(P>0.05),但是无症状期感染者血清白蛋白百分比明显高于AIDS期感染者(P<0.05)。HIV感染者血β2MG与血清γ球蛋白百分比呈正相关:r=0.455(P<0.01),而与血清白蛋白百分比呈负相关:r=-0.586(P<0.01)。HIV感染者血β2MG与CD4计数呈负相关:r=-0.279(P<0.05),也与CD4/CD8比值呈负相关:r=-0.399(P<0.01)。对血β2MG>3.0mg/L的HIV感染者,其血β2MG与CD4计数、CD4/CD8比值呈负相关:r=-0.434、r=-0.427(P<0.01)。几乎所有的HIV感染者肾功能指标都正常。结论绝大多数HIV感染者血β2MG升高,且随着疾病进展而升高,可能与免疫系统被激活和淋巴细胞被破坏有关。HIV感染者血β2MG升高是因机体产生了更多的β2MG,而非因HIV感染者肾小球滤过率降低,滤过功能受损所引起。
Objective To investigate the clinical significance of beta 2 microglobulin (β2MG) in blood of AIDS patients.Methods To detect the levels of β2MG,creatinine,protein electrophoresis in serum and T lymphocyte subsets count in whole blood and analyze the correlations between them.Results About 86.5% (64/74) of HIV/AIDS patients' β2MG in blood were above normal level,which were 90.9%(20/22) and 84.6%(44/52) in asymptomatic HIV infectors and AIDS patients,respectively.The level of β2MG in serum of AIDS patients is significantly higher than that in asymptomatic HIV infectors (P<0.01) and was higher in CD4 below 200/ml than that in CD4 above 200/ml(P<0.05).About 78.8% (67/85) of HIV/AIDS patients' serum γ globulin were above normal level.Serum γ globulin above normal level in AIDS and asymptomatic patients are about 75% (27/36) and 81.6% (40/49),respectively.Serum albumin,but not serum γ globulin in AIDS patients is significantly higher than that in asymptomatic HIV infectors (P<0.01).β2MG in blood positively correlates with serum γ globulin with coefficient r=0.455(P<0.01),while negatively correlates with CD4 count,serum albumin and the ratio of CD4/CD8 with the coefficients r=-0.279(P<0.05),r=- 0.586 and r=-0.399(P<0.01),respectively.β2MG in HIV/AIDS patients above normal level were negatively correlates with CD4 count and the ratio of CD4/CD8 with coefficients r=-0.434(P<0.01) and r=-0.427(P<0.01),respectively.And kidney function of almost all patients in this observation were normal.Conclusions The majority of HIV/AIDS patients' β2MG level in blood were elevated and it was relatively higher with disease progression to AIDS phase.These observations above indicate that the increase of β2MG in blood may relative to the destruction of lymphocyte and activation of immune system in HIV/AIDS infection,and probably due to more β2MG produced by the individuals,but not the decrease of glomerular filtration rate (GFR) of patients' kidney.
出处
《中华实验和临床感染病杂志（电子版）》
CAS
2008年第4期321-326,共6页
Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)
基金
北京市科技计划(D0906003040391)
