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目的探讨淋巴细胞总数与CD4+T淋巴细胞数的相关性,以及其在监测HIV感染者疾病进展和高效抗逆转录病毒治疗疗效中的作用。方法采用Spearman秩和相关和简单回归回顾性分析北京市180例HIV感染者的267全血标本中CD4+T淋巴细胞数和总淋巴细胞数的相关性。根据灵敏度、特异度,阳性预测值和阴性预测值,预测CD4+T淋巴细胞数<200/μl和CD4+T淋巴细胞数<350/μl的总淋巴细胞数临界值。结果北京市2006年进行CD4+T淋巴细胞检测的HIV感染者的总淋巴细胞数同CD4+T淋巴细胞数显著相关。用总淋巴细胞数<1 400/μl预测CD4+T淋巴细胞数<200/μl,敏感性为83.10%、特异性为42.35%、阳性预测值为34.30%、阴性预测值为87.37%;用总淋巴细胞数<1 900/μl预测CD4+T淋巴细胞数<350/μl,敏感性为92.61%、特异性为27.47%、阳性预测值为71.18%、阴性预测值为65.79%。结论在条件有限的地区,可以用总淋巴细胞数预测CD4+T淋巴细胞数,监测HIV感染者疾病的进展情况,粗略判断抗病毒治疗的疗效。
Objective To investigate the correlation between the total number of lymphocytes and the number of CD4 + T lymphocytes and its role in monitoring the progress of disease and the efficacy of antiretroviral therapy in HIV-infected patients. Methods Spearman rank correlation and simple regression were used to analyze the correlation between CD4 + T lymphocytes and total lymphocytes in 267 whole blood samples of 180 HIV-infected persons in Beijing. Based on the sensitivity, specificity, positive predictive value, and negative predictive value, the critical number of total lymphocytes with CD4 + T lymphocytes <200 / μl and CD4 + T lymphocytes <350 / μl was predicted. Results The total number of lymphocytes in CD4 + T lymphocytes in Beijing in 2006 was significantly correlated with the number of CD4 + T lymphocytes. The total number of CD4 + T lymphocytes <200 / μl predicted by total lymphocyte count <1400 / μl was 83.10%, specificity was 42.35%, positive predictive value was 34.30%, negative predictive value was 87.37% The number of lymphocytes <1 900 / μl predicts the number of CD4 + T lymphocytes <350 / μl, with a sensitivity of 92.61%, a specificity of 27.47%, a positive predictive value of 71.18% and a negative predictive value of 65.79%. Conclusion In areas with limited conditions, the total number of lymphocytes can be used to predict the number of CD4 + T lymphocytes, to monitor the progress of disease in HIV-infected patients and to roughly determine the efficacy of antiviral therapy.