CAJ | 학술논문

目的：观察高效抗逆转录病毒疗法（HAART）治疗24周后获得性免疫缺陷综合征（AIDS）患者辅助性17（Th17）细胞和调节性T（Treg）细胞表达水平的变化。方法选取HAART治疗的45例AIDS患者，将其按CD4+T细胞计数分成1～100 cells/μl、101～200 cells/μl和201～350 cells/μl三组，于抗病毒前和抗病毒24周后采集静脉血，运用流式细胞仪检测外周血中CD4+T细胞、Th17和Treg细胞的表达水平，并比较分析其相互关系。结果 AIDS患者治疗24周时Th17细胞在CD4+T细胞中的表达频率为（1.91±0.84）%，而治疗前为（1.31±0.45）%，差异有统计学意义（t=3.67， P＜0.05）； Treg细胞表达频率在治疗24周时和治疗前分别为（5.97±0.93）%和（8.32±1.12）%，差异有统计学意义（t=3.32，P＜0.05）。治疗24周时，Th17细胞明显升高，CD4+T细胞基数为201～350 cells/μl患者组其Th17细胞表达频率显著高于101～200 cells/μl和1～100 cells/μl组患者（t分别=2.68、4.51，P均＜0.05）。 Treg细胞表达频率经治疗后显著下降，CD4+T细胞基数为201～350 cells/μl组患者Treg细胞表达频率下调程度显著高于101～200 cells/μl和1～100 cells/μl组患者（t分别=2.47、3.89，P均＜0.05）。治疗前CD4+T细胞数与Th17表达的百分率呈正相关（r=0.48， P＜0.05），与Treg表达的百分率呈负相关（r=-0.30，P＜0.05）。结论 AIDS患者Th17表达水平下降，Treg表达则上升；HAART治疗能有效地上调Th17表达频率，下调Treg细胞水平；CD4+T细胞基数高的患者较基数低的患者对抗病毒治疗其免疫反应更有效，提示Th17和Treg细胞表达频率可作为HAART治疗有效性的一项判断依据。
목적：관찰고효항역전록병독요법（HAART）치료24주후획득성면역결함종합정（AIDS）환자보조성17（Th17）세포화조절성T（Treg）세포표체수평적변화。방법선취HAART치료적45례AIDS환자，장기안CD4+T세포계수분성1～100 cells/μl、101～200 cells/μl화201～350 cells/μl삼조，우항병독전화항병독24주후채집정맥혈，운용류식세포의검측외주혈중CD4+T세포、Th17화Treg세포적표체수평，병비교분석기상호관계。결과 AIDS환자치료24주시Th17세포재CD4+T세포중적표체빈솔위（1.91±0.84）%，이치료전위（1.31±0.45）%，차이유통계학의의（t=3.67， P＜0.05）； Treg세포표체빈솔재치료24주시화치료전분별위（5.97±0.93）%화（8.32±1.12）%，차이유통계학의의（t=3.32，P＜0.05）。치료24주시，Th17세포명현승고，CD4+T세포기수위201～350 cells/μl환자조기Th17세포표체빈솔현저고우101～200 cells/μl화1～100 cells/μl조환자（t분별=2.68、4.51，P균＜0.05）。 Treg세포표체빈솔경치료후현저하강，CD4+T세포기수위201～350 cells/μl조환자Treg세포표체빈솔하조정도현저고우101～200 cells/μl화1～100 cells/μl조환자（t분별=2.47、3.89，P균＜0.05）。치료전CD4+T세포수여Th17표체적백분솔정정상관（r=0.48， P＜0.05），여Treg표체적백분솔정부상관（r=-0.30，P＜0.05）。결론 AIDS환자Th17표체수평하강，Treg표체칙상승；HAART치료능유효지상조Th17표체빈솔，하조Treg세포수평；CD4+T세포기수고적환자교기수저적환자대항병독치료기면역반응경유효，제시Th17화Treg세포표체빈솔가작위HAART치료유효성적일항판단의거。
Objective To observe the expression levels of Th17 and Treg cells of acquired immune deficiency syn-drome(AIDS) suffered patients after 24 weeks highly active antiretroviral treatment(HAART). Methods According to the CD4+T cell amounts , 45 AIDS patients received HAART treatment were divided into three groups. Flow cytometry technol-ogy was used to detect the CD4+T Cells count, Treg and Th17 cells in peripheral blood at the time of pre-therapy and 24 weeks. Results The ratio of Th17 cells in AIDS patients was (1.91±0.84)%in 24 weeks, and was (1.31±0.45)% at the time of pre-therapy, the difference was significant(t=3.67, P<0.05). The expression level of Treg was (5.97±0.93)%and (8.32±1.12) % at the time of 24 weeks treatment and pre-therapy with statistical significance (t=3.32,P<0.05). Th17 cells expression level was raised after 24 weeks, and which of CD4+T cells for 201~350 cells/μl group showed a remarkable decline than those of CD4+T cells for 101~200 cells/μl and 1~100 cells/μl groups (t=2.68,4.51,P<0.05).Treg cells ex-pression level were down-regulated after 24 weeks treatment, and the dropped levels with of CD4+ T cells for 201~350cells/μl group was higher than those of two other groups(t=2.47,3.89,P<0.05). Th17 cells was significantly positively related to the percentage of CD4+T cells count(r=0.48, P<0.05);the correlation of Treg expression and CD4+T Cells count was significantly negative(r=-0.30, P<0.05) at the time of pre-therapy. Conclusions The expression level of Th17 cells decreased,while Treg cells was increased in AIDS patients; HAART treatment could upregulated Th17 cells level and downregulated Treg cells. The patients with higher baseline of CD4+T cells has higher immune reaction effective than that of the lower baseline CD4+T cells. The Th17 and Treg cells are likely to be the effective indexes to observe HAART progress.