外周血T淋巴细胞亚群在AIDS合并PCP患者中的表达及与复方磺胺甲口恶唑治疗效果的关系

鲍刚; 蒋程媛; 王静; 艾尼瓦尔·吾拉木

doi:10.14009/j.issn.1672-2124.2023.01.005

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外周血T淋巴细胞亚群在AIDS合并PCP患者中的表达及与复方磺胺甲口恶唑治疗效果的关系

论著 | 更新时间：2023-04-14

- 外周血T淋巴细胞亚群在AIDS合并PCP患者中的表达及与复方磺胺甲口恶唑治疗效果的关系
- Expression of T Lymphocyte Subsets in Peripheral Blood of Patients with AIDS Complicated with PCP and Its Correlation with Therapeutic Effect of Compound Sulfamethoxazole
- 中国医院用药评价与分析 2023年第1期页码：27-30
- 作者机构：
  
  新疆医科大学第八附属医院艾滋病诊疗中心
- 作者简介：
- 基金信息：
  
  新疆维吾尔自治区自然科学基金资助项目（No.2017D01C209）
- DOI：10.14009/j.issn.1672-2124.2023.01.005
  中图分类号： R512.91;R563.1
- 纸质出版日期：2023，
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鲍刚, 蒋程媛, 王静, 等. 外周血T淋巴细胞亚群在AIDS合并PCP患者中的表达及与复方磺胺甲口恶唑治疗效果的关系[J]. 中国医院用药评价与分析, 2023,(1):27-30.

BAO Gang, JIANG Chengyuan, WANG Jing, et al. Expression of T Lymphocyte Subsets in Peripheral Blood of Patients with AIDS Complicated with PCP and Its Correlation with Therapeutic Effect of Compound Sulfamethoxazole[J]. 2023,(1):27-30.
鲍刚, 蒋程媛, 王静, 等. 外周血T淋巴细胞亚群在AIDS合并PCP患者中的表达及与复方磺胺甲口恶唑治疗效果的关系[J]. 中国医院用药评价与分析, 2023,(1):27-30. DOI： 10.14009/j.issn.1672-2124.2023.01.005.

BAO Gang, JIANG Chengyuan, WANG Jing, et al. Expression of T Lymphocyte Subsets in Peripheral Blood of Patients with AIDS Complicated with PCP and Its Correlation with Therapeutic Effect of Compound Sulfamethoxazole[J]. 2023,(1):27-30. DOI： 10.14009/j.issn.1672-2124.2023.01.005.

摘要

目的：观察获得性免疫缺陷综合征（AIDS）合并肺孢子菌肺炎（PCP）患者外周血T淋巴细胞亚群的表达，并分析其与复方磺胺甲口恶唑治疗效果的关系。方法：回顾性收集2018—2020年该院收治的AIDS合并PCP患者的资料，全部患者均接受复方磺胺甲口恶唑治疗3周，采用倾向性评分匹配按2∶1匹配后，纳入治疗有效组88例、无效组38例，共126例作为观察组；另收集同期于该院就诊的63例AIDS未合并PCP的患者资料，作为对照组；查阅患者病历资料，统计患者基线资料、实验室指标等，重点分析AIDS合并PCP患者外周血T淋巴细胞亚群（CD3

、CD4

、CD8

和CD4

/CD8

）的表达，及其与复方磺胺甲口恶唑治疗效果的关系。结果：对照组患者系统抗人类免疫缺陷病毒（HIV）治疗占比最高，其次为有效组，无效组最低，组间差异有统计学意义（P＜0.05）;无效组患者治疗前血清LDH、CD8

T淋巴细胞百分比最高，其次为有效组，对照组最低；对照组患者CD4

T淋巴细胞百分比、CD4

/CD8

水平最高，其次为有效组，无效组最低，组间差异有统计学意义（P＜0.05）;组间其他资料、指标比较差异无统计学意义（P＞0.05）;Logistics回归分析结果显示，治疗前LDH水平高、CD8

T淋巴细胞百分比高是AIDS合并PCP患者复方磺胺甲口恶唑治疗无效的危险因素（OR＞1

P＜0.05）

系统抗HIV治疗、CD4

T淋巴细胞百分比高、CD4

/CD8

水平高是其保护因素（OR＜1

P＜0.05）;绘制ROC曲线，结果显示，CD4

、CD8

、CD4

/CD8

预测AIDS合并PCP患者复方磺胺甲口恶唑治疗效果的AUC＞0.70

具有一定的预测价值。结论：CD4

、CD8

和CD4

/CD8

在AIDS合并PCP患者中呈异常表达，且与复方磺胺甲口恶唑的治疗效果有关。

Abstract

OBJECTIVE: To observe the expression of T lymphocyte subsets in peripheral blood of patients with acquired immunodeficiency syndrome（AIDS） complicated with pneumocystis pneumonia（PCP）

and to analyze its correlation with therapeutic effect of compound sulfamethoxazole. METHODS: Data of patients with AIDS complicated with PCP admitted into the hospital from 2018 to 2020 were retrospectively collected. All patients were treated with compound sulfamethoxazole for 3 weeks. After propensity score matching according to 2∶ 1

88 effective patients and 38 ineffective patients were included

a total of 126 cases were set as the observation group; in addition

the data of 63 AIDS patients without PCP admitted into the hospital during the same period were collected and set as the control group. Patients’ medical records were analyzed

and the baseline data and laboratory indicators of the patients were counted. The expression of T lymphocyte subsets（CD3

CD4

CD8

CD4

/CD8

） in peripheral blood in patients with AIDS complicated with PCP and its correlation with therapeutic effect of compound sulfamethoxazole were mainly analyzed. RESULTS: The proportion of systemic anti HIV treatment of patients in the control group was the highest

followed by the effective group

and the ineffective group was the lowest

the differences were statistically significant（P

0.05）. The percentages of serum LDH and CD8

T lymphocytes in the ineffective group were the highest before treatment

followed by the effective group

and the control group was the lowest; the percentage of CD4

T lymphocytes and CD4

/CD8

in the control group were the highest

followed by the effective group

and the ineffective group was the lowest

the differences were statistically significant（P

0.05）; there was no statistical significant difference in other data and indicators between different groups（P

0.05）. Through Logistic regression analysis

high LDH and high percentage of CD8

T lymphocytes before treatment were the risk factors for the ineffective treatment of compound sulfamethoxazole in patients with AIDS complicated with PCP（OR

0.05）

systematic anti HIV treatment and high percentage of CD4

T lymphocytes

high CD4

/CD8

were its protective factors（OR

0.05）. The ROC curve was drawn

and the results showed that the AUC of CD4

CD8

CD4

/CD8

in predicting the therapeutic effect of compound sulfamethoxazole in patients with AIDS complicated with PCP were

0.70

all had certain prediction value. CONCLUSIONS: CD4

CD8

CD4

/CD8

are abnormally expressed in patients with AIDS complicated with PCP

and are related to the therapeutic effect of compound sulfamethoxazole.

关键词

获得性免疫缺陷综合征肺孢子菌肺炎T淋巴细胞亚群复方磺胺甲口恶唑

Keywords

Acquired immune deficiency syndromePneumocystis pneumoniaT lymphocyte subsetsCompound sulfamethoxazole

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