摘要
目的探讨人类免疫缺陷病毒(human immunodeficiency virus,HIV)阳性患者高效抗逆转录病毒治疗血液学指标变化,与临床疾病的关系。方法我院2013年11月-2014年12月收治的100例HIV阳性患者,随机分为两组,55例高效抗逆转录病毒(highly active antiretroviral therapy,HAART)治疗组(On HAART)和45例未进行该治疗的HIV患者为对照组(HAART na?ve),分别采用流式细胞术(flow cytometry,FCM)检测外周血T淋巴细胞亚群百分比、细胞计数,采用核酸荧光染料和FCM检测白细胞计数(white blood cell,WBC)、红细胞计数(red blood cell,RBC)、血色素(hemoglobin,Hgb)、红细胞压积(hematocrit,HCT)、平均RBC体积(mean corpuscular volume,MCV)、平均RBC血红蛋白(mean corpuscular hemoglobin,MCH)、平均血红蛋白浓度(mean corpuscular hemoglobin concentration,MCHC)、RBC分布宽度(red blood cell volume distribution width,RDW)、血小板计数(platelets,PLT)、血小板容积(plateletcrit,PCT)、血小板分布宽度(platelet distribution width,PDW)和血小板平均体积(mean platelet volume,MPV)等,采用免疫比浊法检测凝血酶原时间(prothrombin time,PT)、凝血酶原活动度(prothrombin activity,PTA)水平,并采用荧光定量PCR法检测患者HIV病毒载量(HIVRNA)。观察HIV阳性患者经高效抗逆转录病毒治疗血液学指标变化特点。结果治疗组与对照组在治疗前血液学指标差异无统计学意义(P>0.05)。治疗后治疗组Hgb、MCV、MCH、MCHC、CD4和CD8+T淋巴细胞数(14.2 g/dl、90.5 fl、35.3 pg、336.1 g/L、395.4/μl、795.4/μl)显著高于对照组的(12.7 g/dl、87.5 fl、28.4 pg、322.6 g/L、300.7/μl、679.7/μl)(P<0.05),WBC和RBC水平(4.9×103/μl和4.0×106/μl)显著低于对照组(5.8×103/μl和4.7×106/μl)(P<0.05)。结论高效抗病毒治疗可降低HIV患者贫血和血小板降低发生率,但易发生白细胞、粒细胞和淋巴细胞减少症。临床医生应根据患者血液学指标变化考虑药物组合、疗程和禁忌。
Objective To investigate hematological parameters changes in human immunodeficiency virus（HIV） positive patients taking active antiretroviral treatment and explore its clinical significance. Methods One hundred HIV positive patients admitted to our hospital from November 2013 to December 2014 were enrolled in this study, and they were divided into two groups： highly active antiretroviral therapy（HAART） group（n=55） and HARRT nave group（n=45）. The levels of peripheral blood CD3^＋, CD3^＋ CD4^＋ and CD3^＋CD8^＋ T-lymphocytes were detected by flow cytometry. WBC, RBC, Hgb, HCT, MCV, MCH, MCHC, RDW, PLT, and MPV were determined by nucleic acid fluorescent dye method and flow cytometry. PT and PTA levels were detected by immunoturbidimetry. HIVRNA were determined by fluorescent quantitation PCR methods, and the characteristics of hematological parameters in HIV positive patients taking active antiretroviral treatment were observed. Results There was no statistically significant difference between observation group and control group in hematology indexes（P〉0.05）. Prevalence of anemia, leucopenia, thrombocytopenia, neutropenia and lymphopenia were 12.0%, 36.0%, 4.0%, 28.0% and 5.3% in patients taking HAART and 30.7%, 16.9%, 9.2%, 13.8% and 4.6% in HAART nave patients respectively. There were significant differences in total WBC, RBC, Hgb, MCV, MCH, MCHC, MPV and CD4 counts between patients taking HAART and HAART nave patients（P〈0.05）. Conclusion HAART can reduce the incidence of anemia and thrombocytopenia in patients with HIV, but it is prone to have leucopenia, neutropenia and lymphopenia. Clinicians need to take consideration about drug combination, course of treatment and treatment taboo in HIV positive patients according to changes of hematological indexes.
出处
《解放军医学院学报》
CAS
2015年第8期786-788,793,共4页
Academic Journal of Chinese PLA Medical School
关键词
艾滋病毒
高效抗逆转录病毒治疗
贫血
白细胞减少症
human immunodeficiency virus
highly active antiretroviral therapy
anemia
leucopenia
