周迪 马永娟 王彬

[摘要] 目的 探讨高效联合抗病毒治疗对艾滋病患者外周静脉血CD4+T淋巴细胞计数的影响。 方法 收集2015年3月～2017年4月我市疾病预防控制中心确诊的150例艾滋病患者作为观察对象，均给予高效联合抗病毒疗法（HAART）治疗，记录治疗前及治疗后3个月、6个月、9个月、12个月时患者外周静脉血CD4+T淋巴细胞计数变化情况，并分析影响患者外周静脉血CD4+T淋巴细胞计数增加量的相关因素。 结果 HAART治疗后，150例患者的外周静脉血CD4+T淋巴细胞计数存在随着治疗时间延长而呈现增长的趋势，且治疗3、6、9及12个月时的CD4+T淋巴细胞计数均明显高于治疗前，差异有统计学意义（P<0.05）。性别以及治疗方案对患者外周静脉血CD4+T淋巴细胞计数增加量无明显影响，差异无统计学意义（P>0.05），年龄<40岁、治疗前CD4+T淋巴细胞计数≥200个/μL、BMI≥23 kg/m2及无药物漏服者的CD4+T淋巴细胞计数增加量均明显高于年龄≥40岁、治疗前CD4+T淋巴细胞计数<200个/μL、BMI<23 kg/m2及有药物漏服者，差异有统计学意义（P<0.05）。 结论 高效联合抗病毒治疗有利于提高艾滋病患者外周静脉血CD4+T淋巴细胞计数水平，且治疗效果与患者的年龄、BMI、治疗时机及服药依从性存在相关性。

[关键词] 高效联合抗病毒疗法；艾滋病；人类免疫缺陷病毒；T淋巴细胞计数

[中图分类号] R512.9 [文献标识码] B [文章编号] 1673-9701（2018）25-0131-04

[Abstract] Objective To investigate the effect of highly effective combined antiviral therapy on CD4+T lymphocyte count in peripheral blood of AIDS patients. Methods A total of 150 AIDS patients diagnosed in the Municipal Center for Disease Control and Prevention from March 2015 to April 2017 were enrolled in the study. All patients were treated with high-efficiency combined antiviral therapy（HAART）. Changes in peripheral venous blood CD4+T lymphocyte counts before treatment， at 3 months， 6 months， 9 months and 12 months after treatment were recorded. And the factors affecting the increase in peripheral venous blood CD4+T lymphocyte counts were analyzed. Results After HAART treatment， peripheral blood CD4+T lymphocyte counts in 150 patients showed an increasing trend with prolonged treatment time， and CD4+T lymphocyte counts at 3， 6， 9 and 12 months of treatment were significantly higher than those before treatment， and the difference was statistically significant（P<0.05）. Gender and treatment regimen had no significant effect on the increase of CD4+T lymphocyte count in peripheral venous blood of patients， and the difference was not statistically significant（P>0.05）. The increase of CD4+T lymphocyte counts in patients with age <40 years old， CD4+T lymphocyte count before treatment ≥200個/μL， BMI≥23 kg/m2 and without drug leakage was significantly higher than that of patients with age ≥40 years， CD4+T lymphocyte count before treatment<200个/μL， BMI<23 kg/m2 and drug leakage， and the difference was statistically significant（P<0.05）. Conclusion Efficient combined antiviral therapy is beneficial to improve the peripheral venous blood CD4+ T lymphocyte count in AIDS patients， and the therapeutic effect is related to the patient's age， BMI， treatment timing and medication compliance.

[Key words] Efficient combined antiviral therapy； AIDS； Human immunodeficiency virus； T lymphocyte count

艾滋病（AIDS）是由人类免疫缺陷病毒（HIV）引起的一种传染病，HIV主要侵犯人体CD4+T淋巴细胞，导致其数量上的减少及功能缺陷，引发机体免疫失衡及免疫功能低下，最终导致患者因诱发机会性感染及恶性肿瘤而死亡[1]。现阶段，艾滋病的治疗主要以高效联合抗病毒疗法（HAART）为主，可有效遏制艾滋病的流行、延长HIV感染者的生存期[2]。我市疾病预防控制中心对进行HAART治疗的艾滋病患者，定期检测其CD4+T淋巴细胞计数水平，以判断治疗效果，评估预后，同时重点分析了艾滋病患者HAART治疗中CD4+T淋巴细胞计数的变化及其影响因素，旨在为后续干预提供借鉴。

1 资料与方法

1.1 一般资料

收集2015年3月～2017年4月我市疾病预防控制中心确诊的150例艾滋病患者作为观察对象。……