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目的:研究艾滋病合并乙型肝炎后肝硬化患者血清生化指标及T淋巴细胞亚群水平变化的临床价值。方法:选取2010年5月2016年4月我院收治的艾滋病合并乙型肝炎后肝硬化患者89例为研究组,以同期确诊的150例单纯乙肝肝硬化患者为对照组,均进行对症治疗,比较其肝癌发病率、治疗前后血清病毒载量、γ谷氨酰转移酶(γ-GT)活性及T淋巴细胞亚群(CD3~+、CD4~+、CD8~+)水平。结果:治疗前研究组病毒载量、γ-GT活性高于对照组(P<0.05),CD3~+、CD4~+、CD8~+水平低于对照组(P<0.05);治疗后研究组病毒载量(24.29±1.03)拷贝/mL、γ-GT(56.29±1.28)U/L活性较对照组降低(P<0.05),而其CD3~+(1345.21±6.97)个/μL、CD4~+(286.19±1.97)个/μL、CD8~+(870.65±1.59)个/μL水平较对照组明显升高(P<0.05);观察组肝癌发病率16.85%明显高于对照组5.33%(P<0.05)。结论:艾滋病合并乙型肝炎后肝硬化患者肝癌发病率高于单纯乙肝肝硬化,且其血清生化指标及T淋巴细胞亚群水平在治疗前后发生明显变化,临床应加以监测。
Objective: To study the clinical value of serum biochemical indexes and T lymphocyte subsets in patients with AIDS complicated with hepatitis B cirrhosis. Methods: Select May 2010 April 2016 in our hospital AIDS patients with hepatitis B cirrhosis in 89 cases as the study group, with the same period confirmed 150 cases of pure hepatitis B cirrhosis patients as control group, were symptomatic treatment, The incidence of liver cancer, serum viral load, γ-glutamyl transferase (γ-GT) activity and T lymphocyte subsets (CD3 +, CD4 +, CD8 +) were compared before and after treatment. Results: Before treatment, the viral load and γ-GT activity in the study group were higher than those in the control group (P <0.05). The levels of CD3 +, CD4 + and CD8 + in the study group were lower than those in the control group (24.29 ± 1.03) copies / mL, γ-GT (56.29 ± 1.28) U / L decreased compared with the control group (P <0.05) (286.19 ± 1.97) /μL, CD8 ~ + (870.65 ± 1.59) cells / μL were significantly higher than those in the control group (P <0.05). The incidence of hepatocellular carcinoma in observation group was significantly higher than that in control group (16.85% vs 5.33%, P <0.05). Conclusion: The incidence of hepatocellular carcinoma in patients with AIDS complicated with hepatitis B cirrhosis is higher than that of hepatitis B cirrhosis alone, and the serum biochemical indexes and T lymphocyte subsets change obviously before and after treatment, and should be monitored clinically.