CAJ | 학술논문

目的：探讨艾滋病病毒(HIV)感染者在行腹腔镜手术时其主要淋巴细胞亚群的变化情况,为HIV病毒感染者手术治疗安全性提供依据。方法：选取我院进行手术的16例胆囊疾病患者做研究对象,将其根据HIV阳性与否分为观察组8例,采用免疫印迹法确诊为HIV感染阳性；对照组8例,HIV检测感染为阴性。两组患者采用择期手术行腹腔镜胆囊切除术(LC),并于术前1d、术后3d、7d检测血常规、白蛋白及CD3、CD4、CD8、CD4/CD8百分比情况。观察组采用bDNA方法检测HIV-RNA,并进行统计学处理分析。结果：观察组术后3天、7天外周白细胞总数略低于对照组,差异明显具(P<0.05)。两组患者手术前、后淋巴细胞及中性粒细胞分类百分比比较差异无显著,无统计学意义。两组比较CD4差异显著。观察组术后3天CD4值显著低于术前1天、术后7天,差异显著。对照组术前后CD4无显著差异。两组CD4/CD8比较差异显著(P<0.05)。结论：HIV感染阳性患者在接受腹腔镜胆囊切除术时其主要淋巴细胞亚群免疫功能可被短暂轻度抑制,对手术安全影响轻微,术前检测CD4可作为提高手术安全性的评估指标。
목적：탐토애자병병독(HIV)감염자재행복강경수술시기주요림파세포아군적변화정황,위HIV병독감염자수술치료안전성제공의거。방법：선취아원진행수술적16례담낭질병환자주연구대상,장기근거HIV양성여부분위관찰조8례,채용면역인적법학진위HIV감염양성；대조조8례,HIV검측감염위음성。량조환자채용택기수술행복강경담낭절제술(LC),병우술전1d、술후3d、7d검측혈상규、백단백급CD3、CD4、CD8、CD4/CD8백분비정황。관찰조채용bDNA방법검측HIV-RNA,병진행통계학처리분석。결과：관찰조술후3천、7천외주백세포총수략저우대조조,차이명현구(P<0.05)。량조환자수술전、후림파세포급중성립세포분류백분비비교차이무현저,무통계학의의。량조비교CD4차이현저。관찰조술후3천CD4치현저저우술전1천、술후7천,차이현저。대조조술전후CD4무현저차이。량조CD4/CD8비교차이현저(P<0.05)。결론：HIV감염양성환자재접수복강경담낭절제술시기주요림파세포아군면역공능가피단잠경도억제,대수술안전영향경미,술전검측CD4가작위제고수술안전성적평고지표。
Objective:To explore the changes of major lymphocyte subsets in AIDS virus (HIV) infectors undergoing laparoscopic surgery and provide the basis for the safety of surgical treatment for HIV infectors. Methods:16 patients with gallbladder disease undergoing surgery in our hospital were studied. All subjects were divided into two groups according to the positive or negative HIV, with 8 cases diagnosed positive HIV infection using immunoblotting test as the observation group and 8 cases diagnosed negative HIV infection as the control group. The patients in two groups underwent elective laparoscopic cholecystectomy (LC). Blood routine examinations, albumin and percentages of CD3, CD4, CD8 and CD4/CD8 cell measurements were performed on the 1st preoperative day, the 3rd and the 7th postoperative day. In the observation group, HIV-RNA was detected by bDNA (branched DNA) testing method. The data were analyzed statistically. Results:On the 3rd and the 7th postoperative day, the peripheral WBC (White Blood Cell) count of the observation group was slightly lower than that of the control group(P<0.05). The difference was not statistically significant between differential percentages of lymphocyte and neutrophil of patients in two groups before and after operation. The difference was statistically significant between the CD4 cells of patients in two groups. In the observation group, the CD4 cell count of patients on the 3rd postoperative day was significantly lower than that on the 1st preoperative day and the 7th postoperative day with a significant difference. In the control group, the difference was not significant between the CD4 cells of patients before and after operation. The difference was statistically significant between the CD4/CD8 cells of patients in two groups (P<0.05). Conclusions:The immune function of major lymphocyte subsets may be suppressed transiently and mildly in positive HIV patients undergoing laparoscopic cholecystectomy, which influences surgical safety slightly. Preoperative detection of CD4 cells may be the assessment indicator for improving surgical safety.