CAJ | 학술논문

目的：阐述艾滋病患者外周血B淋巴细胞计数在HAART时的变化，探讨治疗前B淋巴细胞水平对 HAART疗效的影响。方法收集2011年4月至2014年12月门诊治疗的艾滋病患者53例，健康对照者26例；比较艾滋病患者首次 HAART前、治疗3、6、12个月和健康对照的CD4＋ T淋巴细胞、B淋巴细胞。分析HAART治疗12个月后CD4＋ T淋巴细胞和B淋巴细胞水平与治疗前差值（ΔCD4＋ T淋巴细胞和ΔB淋巴细胞）之间的相关性。以首次治疗1年后CD4＋ T淋巴细胞较治疗前升高＞100／μL为有效，将艾滋病患者分为治疗有效组和无效组，比较两组治疗前B淋巴细胞计数。运用受试者工作特征（ROC）曲线寻找进行 HAART的最佳B淋巴细胞计数。两组间均数比较用独立样本 t检验，多组间均数比较用单因素方差分析，两组间数据相关性应用Pearson相关进行分析。结果艾滋病患者在HAART 治疗前，治疗3、6、12个月时B淋巴细胞计数分别为（115．0±41．0）／μL、（130．3±54．1）／μL、（154．2±68．1）／μL和（193．9±84．0）／μL，健康对照为（299．4±125．1）／μL，5组间差异有统计学意义（ F＝24．8，P＜0．01）；治疗后B淋巴细胞呈不同程度升高，治疗3个月内增长缓慢，后期增幅扩大。ΔCD4＋ T淋巴细胞与ΔB淋巴细胞呈正相关（ r＝0．493， P＜0．05）。治疗有效组治疗前B淋巴细胞计数为（130．6±40．4）／μL，无效组为（87．2±24．5）／μL，两组间差异有统计学意义（t＝4．77，P＜0．05）；ROC曲线下面积为0．848。当治疗前B淋巴细胞计数为99．5／μL时，治疗有效的敏感度、特异度分别为82．4％5和84．2％。结论 B淋巴细胞计数在HAART过程中呈不同程度增加，治疗前B淋巴细胞数量对 HAART效果有明显影响。
목적：천술애자병환자외주혈B림파세포계수재HAART시적변화，탐토치료전B림파세포수평대 HAART료효적영향。방법수집2011년4월지2014년12월문진치료적애자병환자53례，건강대조자26례；비교애자병환자수차 HAART전、치료3、6、12개월화건강대조적CD4＋ T림파세포、B림파세포。분석HAART치료12개월후CD4＋ T림파세포화B림파세포수평여치료전차치（ΔCD4＋ T림파세포화ΔB림파세포）지간적상관성。이수차치료1년후CD4＋ T림파세포교치료전승고＞100／μL위유효，장애자병환자분위치료유효조화무효조，비교량조치료전B림파세포계수。운용수시자공작특정（ROC）곡선심조진행 HAART적최가B림파세포계수。량조간균수비교용독립양본 t검험，다조간균수비교용단인소방차분석，량조간수거상관성응용Pearson상관진행분석。결과애자병환자재HAART 치료전，치료3、6、12개월시B림파세포계수분별위（115．0±41．0）／μL、（130．3±54．1）／μL、（154．2±68．1）／μL화（193．9±84．0）／μL，건강대조위（299．4±125．1）／μL，5조간차이유통계학의의（ F＝24．8，P＜0．01）；치료후B림파세포정불동정도승고，치료3개월내증장완만，후기증폭확대。ΔCD4＋ T림파세포여ΔB림파세포정정상관（ r＝0．493， P＜0．05）。치료유효조치료전B림파세포계수위（130．6±40．4）／μL，무효조위（87．2±24．5）／μL，량조간차이유통계학의의（t＝4．77，P＜0．05）；ROC곡선하면적위0．848。당치료전B림파세포계수위99．5／μL시，치료유효적민감도、특이도분별위82．4％5화84．2％。결론 B림파세포계수재HAART과정중정불동정도증가，치료전B림파세포수량대 HAART효과유명현영향。
Objective To elucidate the changes of the peripheral blood B cells in acquired immunodeficiency syndrome (AIDS) patients after the initiation of the highly active antiretroviral therapy (HAART ) ,and to investigate the effect of B cell count on the curative effect of HARRT .Methods Fifty‐three cases of AIDS outpatients and 26 healthy controls were collected between April 2011 and December 2014 . CD4+ T and B lymphocytes counts were compared between the two groups before HAART treatment ,3 ,6 and 12 months after the treatment .The correlation between ΔCD4+ T cells andΔB cells (i .e .the difference value of CD4+ T cells and B cells before HAART treatment and after 12‐month treatment , respectively ) were analyzed . According to whether the CD4+ T lymphocyte count increased by 100/μL after 1 year of the first HAART ,patients were divided into treatment response and nonresponse groups .B cell counts were compared between the two groups ,and the most suitable B cell count to initiate HAART was identified by mean of receiver operating characteristic (ROC) curve .Pre‐and post‐treatment results were compared by paired samples t test .Comparison of measurement data between multiple groups were analyzed by one‐way ANOVA analysis .Correlation between the two groups were analyzed by Pearson correlation analysis .Results B cell counts of AIDS patients before treatment ,3 ,6 and 12 months after treatment were (115 .0 ± 41 .0)/μL ,(130 .3 ± 54 .1)/μL ,(154 .2 ± 68 .1)/μL and (193 .9 ± 84 .0)/μL ,respectively ,while the B cell count of healthy controls was (299 .4 ± 125 .1)/μL . Significant differences among the five groups were observed (F= 24 .8 ,P< 0 .01) .Increases of the B lymphocyte counts with varying degrees were observed after treatments ,which were slow in the initial 3 months and faster afterwards .ΔCD4+ T cell was positively correlated with ΔB cell (r= 0 .493 , P<0 .05) .The B cell counts before treatment in the treatment response and nonresponse groups were (130 .6 ± 40 .4)/μL and (87 .2 ± 24 .5)/μL ,respectively ,which was significantly different (t=4 .77 ,P<0 .05) .The area under the ROC curve was 0 .848 .If the B cell count before treatment was 99 .5/μL ,the sensitivity and specificity to predict effective treatment were 82 .4% and 84 .2% , respectively . Conclusions B cell counts increase with varying degrees during HAART .B cell count before treatment can predict the therapeutic effect of HAART .