HIV患者外周血CD4+/CD25hi/CD127low调节性T细胞的表达及临床意义

摘要

Objective To investigate peripheral blood CD4+/CD25hi/CD127low Regulatory T cel(Treg)levels in HIV patients after antiviral therapy and its clinical significance. Methods Sixty four HIV patients, including 18 cases aged 18~30,35 cases aged 30~45 and 11 cases aged>45 received highly active antiretroviral therapy (HAART). CD4+/CD25hi/CD127low Treg and CD4+T cel s in peripheral blood mononuclear cells (PBMC) were determined by flow cytometry before and 3 months after HAART. Eighty healthy individuals served as controls. Results Before HAART the circulating Treg levels in HIV patients were significantly lower than those in controls(8±2.20, 33±10.03, P<0.01). Treg was positively correlated with CD4+cells in PBMCs (r=0.81, P<0.01) of HIV patients. The circulating levels of Treg were increased 3 months after HAART (P<0.01); the degree of Treg cel ele-vation was associated with the age of patients:4.28-fold for 18~30 age group, 3-fold for 30~45 age group and 2-fold for>45 age group, respectively. Conclusion Highly active antiretroviral therapy can increase the CD4+/CD25hi/CD127low Treg levels in HIV patients, which may be associated with the reduction of viral load.%　　目的探讨感染人类自身免疫缺陷病毒（HIV）患者抗病毒治疗前后外周血CD4+/CD25hi/CD127low调节性T细胞的表达情况及临床意义。方法选择符合HIV诊断标准、接受抗病毒治疗超过3个月的64例患者，采用高效抗逆转录病毒治疗（HARRT），分别于治疗前、治疗3个月后采用流式细胞术检测外周血CD4+/CD25hi/CD127low调节性T细胞和CD4+T细胞的表达情况，并与80例健康体检者（对照组）比较。结果与对照组比较，HIV患者CD4+/CD25hi/CD127low调节性T细胞绝对计数及百分比显著降低，差异有统计学意义（P＜0.01）。HIV患者的CD4+/CD25hi/CD127low调节性T细胞绝对计数和CD4+T细胞呈正相关（P＜0.01）；HIV患者治疗3个月后CD4+/CD25hi/CD127low调节性T细胞均有升高，与治疗前的差异均有统计学意义（均P＜0.01）。根据年龄将患者分为18~30岁、31~45岁、＞45岁，各年龄段患者治疗后CD4+/CD25hi/CD127low调节性T细胞绝对计数分别是治疗前的4.28倍、3.00倍、2.00倍。结论 HIV患者外周血CD4+/CD25hi/CD127low调节性T细胞的表达与病毒的感染、清除有关；外源性药物可升高调节性T细胞的表达。