摘要
目的对比分析维持性血液透析(血透)患者和获得性免疫缺陷综合征(AIDS)患者的免疫功能状态。方法选取2017年5月—8月在会理县人民医院进行长期维持性血透的60例尿毒症患者(维持性血透组)和60例在本院抗病毒中心接受治疗已确诊为AIDS的患者(AIDS组),另选60例常规体检人群作为健康对照组。采用SYSMEX XT-2000 I血球分析仪检测白细胞计数(WBC)和淋巴细胞计数(Lym),采用BDFACSCOUNT流式细胞仪检测CD3^+CD4^+、CD3^+CD8^+和CD3^+T细胞计数和CD4/CD8比值,统计数据并进行分析。结果与健康对照组比较,维持性血透组患者的Lym和CD3^+CD4^+、CD3^+CD8^+、CD3^+T细胞计数均明显降低[Lym(×109/L):1.12(0.85,1.44)比1.91(1.52,2.30),CD3^+CD4^+T细胞(×106/L):414.00(303.00,559.25)比627.00(517.50,823.75),CD3^+CD8^+T细胞(×106/L):271.00(167.50,398.50)比453.00(384.80,620.50),CD3^+T细胞(×106/L):783.00(466.00,999.75)比1 207.00(1 011.50,1 518.00)];AIDS组患者的CD3^+CD4^+T细胞计数和CD4/CD8比值均明显降低[CD3^+CD4^+T细胞(×106/L):433.00(290.25,547.25)比627.00(517.50,823.75),CD4/CD8比值:0.53(0.31,0.78)比1.36(0.95,1.76)],CD3^+CD8^+T细胞计数明显升高[×106/L:819.00(594.50,1 015.80)比453.00(384.80,620.50)],差异均有统计学意义(均P<0.05)。与维持性血透组比较,AIDS组患者的Lym和CD3^+CD8^+、CD3^+T细胞计数均明显升高[Lym(×109/L):1.84(1.62,2.40)比1.12(0.85,1.44),CD3^+CD8^+T细胞(×106/L):819.00(594.50,1 015.80)比271.00(167.50,398.50),CD3^+T细胞(×106/L):1 247.50(1 048.25,1 569.75)比783.00(466.00,999.75)],CD4/CD8比值明显降低[0.53(0.31,0.78)比1.62(1.20,2.10)],差异均有统计学意义(均P<0.05)。3组间WBC比较差异均无统计学意义(均P>0.05)。结论维持性血透患者不同亚群的T细胞均降低,AIDS患者仅CD3^+CD4^+T细胞降低,可认为维持性血透患者的免疫功能紊乱情况较AIDS患者更为严重。
Objective To compare the immune function status in maintenance hemodialysis patients and AIDS patients. Methods Sixty patients with uremia had undergone long-term maintenance hemodialysis and 60 cases had diagnosed as AIDS patients in HuiLi County People＇s Hospital from May to August 2017, and they were respectively assigned in a maintenance hemodialysis group and an AIDS group; in addition, another 60 persons having undergone routine physical examinations were included in a normal control group. The SYSMEX XT-2000 I blood cell analyzer was used to detect the white blood cell count（WBC） and lymphocyte（Lym） count, the BD FACSCOUNT flow cytometry was applied to measure CD3^＋CD4^＋ T cell, CD3^＋CD8^＋ T cell, CD3^＋ T cell and CD4/CD8 ratio, and the data results were statistically analyzed. Results Compared with healthy control group, the numbers of Lym, CD3^＋CD4^＋ T cells, CD3^＋CD8^＋ T cells, CD3^＋ T cells in the patients of maintenance hemodialysis group were significantly lower [Lym（×10^9/L）： 1.12（0.85, 1.44） vs. 1.91（1.52, 2.30）, CD3^＋CD4^＋ T cell（×10^6/L）： 414.00（303.00, 559.25） vs. 627.00（517.50, 823.75）, CD3^＋CD8^＋ T cell（×10^6/L）： 271.00（167.50, 398.50） vs. 453.00（384.80, 620.50）, CD3^＋ T cell（×10^6/L）： 783.00（466.00, 999.75） vs. 1 207.00（1 011.50, 1 518.00）]; the numbers of CD3^＋CD4^＋ T cells and the CD4/CD8 ratio in patients of AIDS group were lower than those in normal control group [CD3^＋CD4^＋ T cell（×10^6/L）： 433.00（290.25, 547.25） vs. 627.00（517.50, 823.75）, CD4/CD8 ratio： 0.53（0.31, 0.78） vs. 1.36（0.95, 1.76）], CD3^＋CD8^＋ T cells was obviously higher than that of the normal population [CD3^＋CD8^＋T cell（×10^6/L）： 819.00（594.50, 1 015.80） vs. 453.00（384.80, 620.50）]; the differences in the above indexes were statistically significant（all P〈0.05）. Compared with the maintenance hemodialysis group, the numbers of Lym, CD3^＋CD8^＋ T cells and CD3^＋ T cells in patients of AIDS group were markedly higher [Lym（×10^9/L）： 1.84（1.62, 2.40） vs. 1.12（0.85, 1.44）, CD3^＋CD8^＋ T cell（×10^6/L）： 819.00（594.50, 1 015.80） vs. 271.00（167.50, 398.50）, CD3^＋ T cell（×10^6/L）： 1 247.50（1 048.25, 1 569.75） vs. 783.00（466.00, 999.75）], while CD4/CD8 ratio was significantly lower [0.53（0.31, 0.78） vs. 1.62（1.20, 2.10）], the differences in the above indexes were statistically significant（all P〈0.05）. And there were no significant differences statistically in WBC number between any pair comparison in the 3 groups（all P〈0.05）. Conclusions In patients of maintenance hemodialysis group, all the different T cell subsets are decreased, while in the patients in AIDS group, only are CD3^＋CD4^＋ T cells decreased. Therefore, it may be recognized that the immune dysfunction status in patients with maintenance hemodialysis is severer than that in patients with AIDS.
作者
陈凤莹
刘克芳
袁珍朝
Chen Fengying;Liu Kefang;Yuan Zhenchao(Department of Clinical Laboratory,Huili County People＇s Hospital,Huili 615100,Sichuan,China)
出处
《实用检验医师杂志》
2018年第3期145-147,共3页
Chinese Journal of Clinical Pathologist
