CAJ | 학술논문

目的探讨人免疫缺陷病毒感染者/艾滋病患者（简称HIV感染者/AIDS患者）浅表淋巴结肿大的病理改变及其与CD4+T淋巴细胞计数的相关性。方法对1066例HIV感染者/AIDS患者浅表淋巴结肿大的发生情况及其外周血CD4+T淋巴细胞计数进行分析；并对浅表淋巴结肿大患者行淋巴结活检。结果在1066例HIV感染者/AIDS患者中有126例出现浅表淋巴结肿大，发生率为11.8％，其中17例检出合并有两种类型的病理改变。CD4+T淋巴细胞计数＜100个/μl有69例，包括结核病37例，淋巴结反应性增生8例，艾滋病相关淋巴结病18例，青霉病12例，真菌感染5例，非结核分枝杆菌感染1例；CD4+T淋巴细胞计数（100～200）个/μl有26例，包括结核病12例，淋巴结反应性增生8例，艾滋病相关淋巴结病6例，青霉病2例，非霍奇金淋巴瘤1例；CD4+T淋巴细胞计数＞200个/μl有31例，包括结核病11例，淋巴结反应性增生12例，艾滋病相关淋巴结病3例，青霉病1例，非霍奇金淋巴瘤4例。合并浅表淋巴结肿大的结核病、艾滋病相关淋巴结病及青霉病患者的CD4+T淋巴细胞计数比较差异有统计学意义(x2 =8.861,P=0.O12)。另外，浅表淋巴结肿大的发生率与CD4+T淋巴细胞计数存在相关性(X2=375.41，P=0.000)。结论导致HIV感染者/AIDS患者浅表淋巴结肿大的最常见疾病为结核病，其次为淋巴结反应性增生、艾滋病相关淋巴结病、青霉病。CD4+T淋巴细胞计数越低，发生浅表淋巴结肿大的几率越高，合并机会性感染的风险也越大，测定外周血CD4+T淋巴细胞计数对HIV感染者/AIDS患者浅表淋巴结肿大的早期诊断与治疗有指导意义。
목적 탐토인면역결함병독감염자/애자병환자（간칭HIV감염자/AIDS환자）천표림파결종대적병리개변급기여CD4+T림파세포계수적상관성。방법 대1066례HIV감염자/AIDS환자천표림파결종대적발생정황급기외주혈CD4+T림파세포계수진행분석；병대천표림파결종대환자행림파결활검。결과 재1066례HIV감염자/AIDS환자중유126례출현천표림파결종대，발생솔위11.8％，기중17례검출합병유량충류형적병리개변。CD4+T림파세포계수＜100개/μl유69례，포괄결핵병37례，림파결반응성증생8례，애자병상관림파결병18례，청매병12례，진균감염5례，비결핵분지간균감염1례；CD4+T림파세포계수（100～200）개/μl유26례，포괄결핵병12례，림파결반응성증생8례，애자병상관림파결병6례，청매병2례，비곽기금림파류1례；CD4+T림파세포계수＞200개/μl유31례，포괄결핵병11례，림파결반응성증생12례，애자병상관림파결병3례，청매병1례，비곽기금림파류4례。합병천표림파결종대적결핵병、애자병상관림파결병급청매병환자적CD4+T림파세포계수비교차이유통계학의의(x2 =8.861,P=0.O12)。령외，천표림파결종대적발생솔여CD4+T림파세포계수존재상관성(X2=375.41，P=0.000)。결론 도치HIV감염자/AIDS환자천표림파결종대적최상견질병위결핵병，기차위림파결반응성증생、애자병상관림파결병、청매병。CD4+T림파세포계수월저，발생천표림파결종대적궤솔월고，합병궤회성감염적풍험야월대，측정외주혈CD4+T림파세포계수대HIV감염자/AIDS환자천표림파결종대적조기진단여치료유지도의의。
Objective To explore the clinicopathological correlation between CD4+ T lymphocyte count and superficial lymphadenopathy HIV/AIDS patients. Methods A total of 1066 HIV/AIDS patients were included in this study. The incidence of superficial lymphadenopathy, peripheral blood CD4+ T lymphocyte counts and histological features of superficial lymphadenopathy were analyzed. Results Among 1066 patients, 126 cases (11.8％) presented with superficial lymphadenopathy. Of the 126 cases, there were 69 cases with CD4+ T lymphocyte counts ＜ 100/μl and clinical diagnoses including tuberculosis (37 cases), reactive hyperplasia (8 cases), AIDS-related lymphadenopathy (18 cases), penicillium diseases (12 cases), fungal infection (5 cases) and non-tuberculous mycobacterial infection (1 case).Twenty-six cases had CD4 + T lymphocyte counts between 100/μl to 200/μl and clinical diagnosis including tuberculosis ( 12 cases ), reactive hyperplasia ( 8 cases ), AIDS-related lymphadenopathy ( 6 cases ),penicillium disease (2 cases) and non-Hodgkin lymphoma ( 1 case ). Twenty-nine cases had CD4 + T lymphocyte counts ＞ 200/μl and clinical diagnoses including tuberculosis ( 11 cases), reactive hyperplasia ( 12 cases), AIDS-related lymphadenopathy ( 3 cases), Penicillium diseases ( 1 case) and non-Hodgkin lymphoma (4 cases). The CD4 + T lymphocyte counts among patients with tuberculosis, AIDS-related lymphadenopathy and Penicillium diseases were significantly different (x2 =8. 861, P =0. 012 ). A significant correlation between the incidence of superficial lymphadenopathy and CD4 + T lymphocyte counts was found (x2 =375.41, P =0.000 ). ConclusionsThe most common cause of superficial lymphadenopathy in HIV/AIDS patients is tuberculosis, followed by lymph node reactive hyperplasia, AIDSrelated lymphadenopathy and Penicillium disease. Low CI4 + T lymphocyte count correlates with an increased incidence of superficial lymphadenopathy and the risk of opportunity infection. Therefore,determination of peripheral blood CD4+ T lymphocyte count should become an integral marker for the early diagnosis and treatment of superficial lymphadenopathy in HIV/AIDS patients.