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目的研究艾滋病病毒(HIV)感染者外周血中自然杀伤细胞(NK cells)亚群的比例,各亚群细胞对CD32A/CD32B/CD57的表达水平,高效抗反转录病毒治疗(HAART)与疾病进展的相关性。方法对未经治疗的慢性HIV感染者35例和进展期患者23例,分析NK细胞各亚群的比例,各亚群细胞对CD32A/CD32B/CD57的表达水平,CD4+T淋巴细胞(简称CD4细胞)、CD8+T淋巴细胞(简称CD8细胞)计数及CD4/CD8比值,并对以上各因素进行相关性分析。以上患者中选14例慢性HIV感染者、10例进展期患者进行HAART治疗(替诺福韦+拉米夫定+依非韦伦)6个月,分析治疗对以上因素的影响。结果机体感染HIV后,CD56dimNK细胞的比例下降,CD56neg NK细胞的比例升高(P<0.0005);CD57+CD56dimNK细胞、CD57+CD56neg NK细胞的比例下降(P<0.05),CD32B+CD56dim NK细胞、CD32B+CD56neg NK细胞的比例升高(P<0.05)。CD56dimNK细胞比例与CD4/CD8比值正相关(P=0.0176,r2=0.0813),CD56neg NK细胞比例与CD4/CD8比值呈负相关(P=0.0293,r2=0.0689)。经过治疗的慢性HIV患者的CD56bright NK细胞的比例降低(P<0.05),所有患者的CD4细胞计数及CD4/CD8比值升高(P<0.01)。结论 HIV通过抑制NK细胞成熟增加抑制型受体表达,改变NK细胞亚群比例来抑制NK细胞功能。有效的HAART治疗可以恢复HIV患者CD4细胞计数及CD4/CD8比值,促进免疫重建,降低死亡概率。
Objective To study the proportion of NK cell subsets in peripheral blood of people living with HIV (HIV), the expression of CD32A / CD32B / CD57 in each subpopulation, HAART and disease Progress relatedness. Methods Thirty-five patients with untreated chronic HIV infection and 23 patients with advanced disease were enrolled in this study. The proportion of NK cell subsets, the expression levels of CD32A / CD32B / CD57, CD4 + T lymphocytes (CD4 Cells), CD8 + T lymphocytes (CD8 cells for short) count and CD4 / CD8 ratio, and the above factors were analyzed. Among the above patients, 14 patients with chronic HIV infection and 10 patients with advanced disease were treated with HAART (tenofovir plus lamivudine plus efavirenz) for 6 months to analyze the effect of treatment on these factors. Results The percentage of CD56dimNK cells decreased and the proportion of CD56neg NK cells increased (P <0.0005). The percentage of CD57 + CD56dimNK cells and CD57 + CD56neg NK cells decreased (P <0.05) The proportion of CD32B + CD56neg NK cells increased (P <0.05). The proportion of CD56 negative NK cells was positively correlated with CD4 / CD8 ratio (P = 0.0176, r2 = 0.0813). The proportion of CD56neg NK cells was negatively correlated with CD4 / CD8 ratio (P = 0.0293, r2 = 0.0689). The proportion of CD56bright NK cells in treated chronic HIV patients decreased (P <0.05), and the CD4 cell count and CD4 / CD8 ratio increased in all patients (P <0.01). Conclusion HIV can inhibit the function of NK cells by inhibiting the maturation of NK cells and increasing the expression of inhibitory receptors and the proportion of NK cells. Effective HAART treatment can restore HIV CD4 CD4 count and CD4 / CD8 ratio, promote immune reconstitution and reduce the probability of death.