中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2012年
9期
708-712
,共5页
郑煜煌%Diallo Mamadou Alius%陈霞%何艳%贺波%贺梅%王红艳%肖水灵%罗艳%姚运海%林一鹤%谌资%周华英
鄭煜煌%Diallo Mamadou Alius%陳霞%何豔%賀波%賀梅%王紅豔%肖水靈%囉豔%姚運海%林一鶴%諶資%週華英
정욱황%Diallo Mamadou Alius%진하%하염%하파%하매%왕홍염%초수령%라염%요운해%림일학%심자%주화영
HIV%淋巴细胞%单核细胞%高效抗逆转录病毒治疗%病毒储存库
HIV%淋巴細胞%單覈細胞%高效抗逆轉錄病毒治療%病毒儲存庫
HIV%림파세포%단핵세포%고효항역전록병독치료%병독저존고
HIV%Lymphocytes%Monocytes%Highly active antiretroviral therapy%Viral reservoirs
目的 观察中国艾滋病患者外周血T淋巴细胞及单核细胞作为HIV-1病毒储存库的情况,了解其在接受48周高效抗逆转录病毒治疗( HAART)中的动态变化及其临床意义.方法 35例慢性HIV-1感染的成人在初治HAART的0、24、48周,使用流式细胞仪测定血T淋巴细胞亚群数量,使用磁珠分选法从外周血单个核细胞中分离T淋巴细胞和单核细胞并提取细胞DNA,采用实时荧光定量RT-PCR法检测血清HIV RNA、用SYBR Green实时PCR对T淋巴细胞和单核细胞内的前病毒HIV DNA载量进行定量测定；使用SPSS 18.0软件对收集的数据进行分析.结果 35例艾滋病患者在HAART初次启动的0、24、48周,外周血HIV RNA水平分别为(4.12±1.41)、≤1.69、≤1.69lg拷贝/ml,CD4+ T淋巴细胞数分别为(196±101)、(321±112)、(392±127)个/μl；在T淋巴细胞中HIV DNA水平分别为(4.03±0.53)、(2.74±1.16)、(2.45±0.41)lg拷贝/106细胞,在单核细胞中HIV DNA水平分别为(2.51 ±0.68)、(2.16±0.34)、(2.03±0.25) lg拷贝/106细胞.统计学分析显示,在48周HAART过程中,外周血HIV RNA水平与CD4+ T淋巴细胞数呈负相关,与T淋巴细胞及单核细胞中的前病毒HIV DNA水平均呈正相关；T淋巴细胞中的HIV DNA下降速度慢于单核细胞；外周血CD4+ T淋巴细胞与T淋巴细胞前病毒HIV DNA载量呈负相关.结论 HIV感染者T淋巴细胞和单核细胞均可作为HIV病毒储存库,而淋巴细胞是更主要的储存库细胞；细胞内HIV DNA水平与血HIV RNA水平变化正相关,与血CD4+T淋巴细胞数呈负相关,T淋巴细胞内前病毒HIV DNA水平变化可能作为HAART中AIDS病程进展的观察指标之一.
目的 觀察中國艾滋病患者外週血T淋巴細胞及單覈細胞作為HIV-1病毒儲存庫的情況,瞭解其在接受48週高效抗逆轉錄病毒治療( HAART)中的動態變化及其臨床意義.方法 35例慢性HIV-1感染的成人在初治HAART的0、24、48週,使用流式細胞儀測定血T淋巴細胞亞群數量,使用磁珠分選法從外週血單箇覈細胞中分離T淋巴細胞和單覈細胞併提取細胞DNA,採用實時熒光定量RT-PCR法檢測血清HIV RNA、用SYBR Green實時PCR對T淋巴細胞和單覈細胞內的前病毒HIV DNA載量進行定量測定；使用SPSS 18.0軟件對收集的數據進行分析.結果 35例艾滋病患者在HAART初次啟動的0、24、48週,外週血HIV RNA水平分彆為(4.12±1.41)、≤1.69、≤1.69lg拷貝/ml,CD4+ T淋巴細胞數分彆為(196±101)、(321±112)、(392±127)箇/μl；在T淋巴細胞中HIV DNA水平分彆為(4.03±0.53)、(2.74±1.16)、(2.45±0.41)lg拷貝/106細胞,在單覈細胞中HIV DNA水平分彆為(2.51 ±0.68)、(2.16±0.34)、(2.03±0.25) lg拷貝/106細胞.統計學分析顯示,在48週HAART過程中,外週血HIV RNA水平與CD4+ T淋巴細胞數呈負相關,與T淋巴細胞及單覈細胞中的前病毒HIV DNA水平均呈正相關；T淋巴細胞中的HIV DNA下降速度慢于單覈細胞；外週血CD4+ T淋巴細胞與T淋巴細胞前病毒HIV DNA載量呈負相關.結論 HIV感染者T淋巴細胞和單覈細胞均可作為HIV病毒儲存庫,而淋巴細胞是更主要的儲存庫細胞；細胞內HIV DNA水平與血HIV RNA水平變化正相關,與血CD4+T淋巴細胞數呈負相關,T淋巴細胞內前病毒HIV DNA水平變化可能作為HAART中AIDS病程進展的觀察指標之一.
목적 관찰중국애자병환자외주혈T림파세포급단핵세포작위HIV-1병독저존고적정황,료해기재접수48주고효항역전록병독치료( HAART)중적동태변화급기림상의의.방법 35례만성HIV-1감염적성인재초치HAART적0、24、48주,사용류식세포의측정혈T림파세포아군수량,사용자주분선법종외주혈단개핵세포중분리T림파세포화단핵세포병제취세포DNA,채용실시형광정량RT-PCR법검측혈청HIV RNA、용SYBR Green실시PCR대T림파세포화단핵세포내적전병독HIV DNA재량진행정량측정；사용SPSS 18.0연건대수집적수거진행분석.결과 35례애자병환자재HAART초차계동적0、24、48주,외주혈HIV RNA수평분별위(4.12±1.41)、≤1.69、≤1.69lg고패/ml,CD4+ T림파세포수분별위(196±101)、(321±112)、(392±127)개/μl；재T림파세포중HIV DNA수평분별위(4.03±0.53)、(2.74±1.16)、(2.45±0.41)lg고패/106세포,재단핵세포중HIV DNA수평분별위(2.51 ±0.68)、(2.16±0.34)、(2.03±0.25) lg고패/106세포.통계학분석현시,재48주HAART과정중,외주혈HIV RNA수평여CD4+ T림파세포수정부상관,여T림파세포급단핵세포중적전병독HIV DNA수평균정정상관；T림파세포중적HIV DNA하강속도만우단핵세포；외주혈CD4+ T림파세포여T림파세포전병독HIV DNA재량정부상관.결론 HIV감염자T림파세포화단핵세포균가작위HIV병독저존고,이림파세포시경주요적저존고세포；세포내HIV DNA수평여혈HIV RNA수평변화정상관,여혈CD4+T림파세포수정부상관,T림파세포내전병독HIV DNA수평변화가능작위HAART중AIDS병정진전적관찰지표지일.
Objective To observe the dynamic changes of peripheral blood T lymphocytes and monocytes,which serve as HIV-1 viral reservoirs,in Chinese HIV-infected patients receiving highly-active antiretroviral treatment ( HAART ) for 48 weeks and its clinical significance. Methods A total of 35 chronic HIV-1 infected adults naively received HAART.The peripheral blood T lymphocyte subsets counts were determined by flux cytometry at week 0,24 and 48.Magnetic activated cell sorting was used to extract cellular DNA from monocytes and T lymphocytes purified from peripheral blood mononuclear cells.Real-time fluorescent quantitative PCR was used to detect the serum HIV RNA and HIV DNA of monocytes and T lymphocytes.SPSS 18.0 software was used to analyze the collected data.Results At week 0,24,and 48 after initiation of HAART,HIV RNA levels of peripheral blood were (4.12 ± 1.41 ),≤1.69,and ≤1.69 lg copies/ml,respectively ; CD4+ T cells were ( 196 ± 101 ),(321.90 ± 112) and ( 392 ± 127 ) cells/μl,respectively ; HIV DNA level in T lymphocytes were ( 4.03 ± 0.53 ),( 2.74 ± 1.16 ) and ( 2.45 ± 0.41 )lg copies/106 cells respectively; while in monocytes,HIV DNA levels were (2.51 ±0.68),(2.16 ±0.34) and (2.03 ± 0.25 )lg copies/106 cells.Statistical analysis revealed that HIV RNA level was negatively correlated with the CD4+ T cell count through the whole trail,while positively correlated with the HIV DNA level in blood T lymphocytes and monocytes.HIV DNA level in T lymphocytes decreased more slowly than HIV DNA in monocytes. Moreover,peripheral blood CD4+ T cell count was negatively associated with the HIV DNA capacity from T lymphocytes.Conclusions Both T lymphocyte and monocyte may serve as viral reservoirs,and T lymphocyte might play a more important role as HIV reservoirs. The blood HIV RNA is correlated positively with the cellular HIV DNA,whereas,CD4+ T cell count is correlated negatively with HIV DNA from lymphocytes,which suggests that HIV DNA levels in T lymphocyte might be one of indicators of AIDS progress during HAART.
