CAJ | 학술논문

目的通过对HIV感染者和AIDS患者血常规总淋巴细胞数(TLC)、Hb、PLT、WBC与CD4+ T淋巴细胞计数相关性的研究,探讨用血常规多项指标检测联合预测HIV/AIDS患者CD4+ T淋巴细胞计数的可行性.方法 778例HIV/AIDS患者共采集1 038份血样,血常规中四项指标:TLC、Hb、WBC、PLT与CD4+T淋巴细胞计数相关分析采用Spearman秩和相关.绘制受试者工作特征(ROC)曲线以判断各项指标预测CD4+T淋巴细胞计数的真实度及其最佳临界值,计算各临界值的敏感度、特异度、阳性预测值和阴性预测值.采用联合试验评价多指标联合预测CD4+ T淋巴细胞计数<200个/μl的可行性.结果 TLC、Hb、WBC、PLT与CD4+T淋巴细胞计数之间均存在正相关,相关系数分别为r=0.64,P=0.000;r=0.36,P=0.000;r=0.24,P=0.000;r=0.09,P=0.000.TLC、Hb预测CD4+ T淋巴细胞计数的ROC曲线下面积分别在0.82～0.84、0.66～0.70之间.单独使用TLC预测CD4+ T淋巴细胞计数<50、200、350个/μl的最佳临界值分别为TLC<1 100 × 106/L、1 200 ×106/L、1 400 × 106/L.TLC<1 200 × 106/L与Hb<120 g/L联合预测CD4+ T淋巴细胞计数<200个/μl的敏感度为45.3%,特异度为82.8%.结论本研究结果显示TLC<1 200 ×106/L与Hb<120g/L联合预测CD4+ T淋巴细胞计数<200个/μl的临床使用价值不高.
목적 통과대HIV감염자화AIDS환자혈상규총림파세포수(TLC)、Hb、PLT、WBC여CD4+ T림파세포계수상관성적연구,탐토용혈상규다항지표검측연합예측HIV/AIDS환자CD4+ T림파세포계수적가행성.방법 778례HIV/AIDS환자공채집1 038빈혈양,혈상규중사항지표:TLC、Hb、WBC、PLT여CD4+T림파세포계수상관분석채용Spearman질화상관.회제수시자공작특정(ROC)곡선이판단각항지표예측CD4+T림파세포계수적진실도급기최가림계치,계산각림계치적민감도、특이도、양성예측치화음성예측치.채용연합시험평개다지표연합예측CD4+ T림파세포계수<200개/μl적가행성.결과 TLC、Hb、WBC、PLT여CD4+T림파세포계수지간균존재정상관,상관계수분별위r=0.64,P=0.000;r=0.36,P=0.000;r=0.24,P=0.000;r=0.09,P=0.000.TLC、Hb예측CD4+ T림파세포계수적ROC곡선하면적분별재0.82～0.84、0.66～0.70지간.단독사용TLC예측CD4+ T림파세포계수<50、200、350개/μl적최가림계치분별위TLC<1 100 × 106/L、1 200 ×106/L、1 400 × 106/L.TLC<1 200 × 106/L여Hb<120 g/L연합예측CD4+ T림파세포계수<200개/μl적민감도위45.3%,특이도위82.8%.결론본연구결과현시TLC<1 200 ×106/L여Hb<120g/L연합예측CD4+ T림파세포계수<200개/μl적림상사용개치불고.
Objective To determine the feasibility of human routine blood tests as a surrogate for CD4+ T cell count through studying the correlation of CD4+ T cell count with total lymphocyte count(TLC),hemoglobin(Hb),blood platelet(PLT),and white cell count(WBC)in HIV/AIDS patients.Methods 1 038 person-time blood tests among 778 HIV/AIDS patients were performed and Spearman correlation analysis was used.Predictive power and the cut-off for potential predictors of CD4+ T cell count were assessed through receiver operating characteristic(ROC)curves.Combination test was used to assess the capability of multipie indexes to serve as surrogate markers for CD4+ T cell counL Results Significant correlations with CD4+ T cell count were observed for TLC,Hb,PLT and WBC.The Spearman correlation coefficients were r=0.64,P=0.000;r=0.36,P=0.000;r=0.24,P=0,000;r=0.09,P=0.000,respectively.No correlation between TLC and CD4+ T cell count was found when,TLC was more than 2 000 × 106/L(r=0.12,P=0.15).The areas under ROC curve of TLC and Hb for predicting CD4+ T cell count were between 0.82 to 0.84,and 0.66 to 0.70,respectively.When CD4+ T cell count were less than 50,200,350 cells/μl respectively,the optional cut-off value was TLC＜1 100 × 106/L,1 200 × 106/L and 1 400 × 106/L.When the study combined TLC＜1 200 × 106/L and Hb＜120 g/L for prediction of CD4+ T cell count＜200/μl,the sensitivity was 45.3% and specificity was 82.8%.Conclusion There is no significant application value for combination of TLC＜1 200×106/L and Hb＜120 g/L as a surrogate for prediction of CD4+ T cell count＜200/μl.