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目的探讨AIDS患者胃黏膜CD4+T淋巴细胞的丢失、重建与HIV感染的关系。方法对35例AIDS患者胃黏膜组织冰冻切片和PBMC涂片采用核酸原位杂交方法及免疫组化双重染色,观察CD4+T淋巴细胞的HIV感染情况。结果①高效抗逆转录病毒治疗(HAART)治疗1～4年后,AIDS患者胃黏膜单个核细胞(MMC)中CD4+T细胞计数仍然低于对照组[(37.44±18.00]%vs(50.35±3.41)%](P<0.01);但PBMC中CD4+T细胞计数与对照组无显著性差异[(42.70±10.66)%vs(51.00±6.60)%](P>0.05)。②未治疗组与治疗<1年组胃黏膜MMC中CD4+T细胞HIV阳性率无显著性差异[(2.76±1.92)%vs(1.88±1.56)%](P>0.05);治疗1～4年组则明显低于未治疗组[(0.54±0.49)%vs(2.76±1.92)%(P<0.01);三组AIDS患者PBMC中CD4+T细胞HIV感染率均具有显著性差异[(19.44±8.17)%vs(9.76±6.98)%vs(4.95±8.26)%](P<0.05)。结论相对于外周血,AIDS患者胃黏膜免疫重建可能是不完全的。AIDS患者胃黏膜CD4+T细胞HIV感染在胃黏膜CD4+T细胞的丢失与重建延迟过程中可能并非发挥主要的作用。
Objective To investigate the relationship between loss and reconstruction of CD4 + T lymphocytes in AIDS patients and HIV infection. Methods 35 cases of AIDS patients with gastric mucosal frozen sections and PBMC smears using nucleic acid in situ hybridization and immunohistochemical double staining to observe the HIV infection of CD4 T lymphocytes. Results ① CD4 + T cell counts in gastric mucosal mononuclear cells (MMC) in AIDS patients after HAART treatment for 1 to 4 years were still lower than those in the control group [(37.44 ± 18.00)% vs (50.35 ± (P <0.01). However, there was no significant difference in CD4 + T cell count between PBMC and control group [(42.70 ± 10.66)% vs (51.00 ± 6.60)%] There was no significant difference in the positive rate of CD4 + T cells in gastric mucosal MMC between treatment <1 year (2.76 ± 1.92)% vs (1.88 ± 1.56)%] (P> 0.05) (0.54 ± 0.49)% vs (2.76 ± 1.92)% (P <0.01). The HIV infection rates of CD4 + T cells in PBMC of three AIDS patients were significantly different (19.44 ± 8.17% (9.76 ± 6.98)% vs (4.95 ± 8.26)%, respectively (P <0.05) .Conclusion Immune remodeling of gastric mucosa may not be complete in patients with AIDS compared with peripheral blood.AIV patients with gastric mucosal CD4 + T cell HIV infection Gastric mucosal CD4 + T cell loss and reconstruction delay may not play a major role.