目的 探讨人类免疫缺陷病毒/丙型肝炎病毒(HIV/HCV)混合感染者的免疫淋巴细胞亚群和肝脏生化指标的特征。方法 检测并分析研究组(40例混合感染HIV/HCV的血友病患者)和对照组(12例单独感染HIV的血友病患者)若干相关实验室指标。结果两组(研究与对照)结果 差异显著的指标分别为:自然杀伤(NK)细胞9.26%±5.98%对12.19%±5.80%,P<0.05;CD4/CD8细胞比值0.39±0.21对0.53±0.24,P<0.05;CD3细胞74.99%±10.33%对68.42%±8.82%,P<0.05;CD8细胞52.28%±12.59%对43.58%±10.99%,P<0.05;丙氨酸氨酶(ALT)(48.59±40.21)U/L对(26.87±27.23)U/L,P<0.01;天冬氨酸转氨酶(AST)(61.66±51.02)U/L对(34.17±30.24)U/L,P<0.001;谷氨酰转肽酶(GGT)(136.50±111.50)U/L对(43.88±36.17)U/L,P<0.001;甘胆酸(CG)(683.41±962.22)μg/L对(250.96±290.81)μg/L,P<0.001;透明质酸(HA)(180.94±196.69)ng/ml对(64.68±32.74)ng/ml,P<0.001;白/球蛋白(A/G)比值1.35±0.24对1.50±0.34,P<0.05。与单独HIV感染者比较,HIV/HCV混合感染者的NK细胞、CD4/CD8细胞比值和A/G比值显著降低,而ALT、AST、GGT、CG和HA的水平显著增加。结论 HIV/HCV混合感染可能加剧患者淋巴细胞亚群的不平衡,加重肝脏损伤和出现肝硬化趋势。

Objective To explore the characteristics of immune lymphocyte subpopulation and liver biochemical markers in patients with HIV/HCV co-infection.Methods Some related laboratory makers of peripheral blood in the study group(40 hemophiliac patients with HIV/HCV co-infection)and in the control group(12 hemophiliac patients with HIV infection only)were detected and analyzed.Results There were significant differences between results of the two groups(study and the control)were in following:NK cell(9.26±5.98)% vs(12.19±5.80)%,P<0.05.The rate of CD4/CD8 0.39±0.21 vs 0.53±0.24,P<0.05.CD3(74.99±10.33)% vs(68.42±8.82)%,P<0.05.CD8(52.28±12.59)% vs(43.58±10.99)%,P<0.05.ALT(48.59±40.21)U/L vs(26.87±27.23)U/L,P<0.001.AST(61.66±51.02)U/L vs(34.17±30.24)U/L,P<0.001.GGT(136.50±111.50)U/L vs(43.88±36.17)U/L,P<0.001.CG(683.41±962.22)μg/dL vs(250.96±290.81)μg/dL,P<0.001.Hyaluronic acid(180.94±196.69)ng/mL vs(64.68±32.74)ng/mL,P<0.001.Albumin/globin(1.35±0.24)vs(1.50 ±0.34),P<0.05.Comparing with the patients infected with HIV only,NK cell,rates of CD4/CD8 and albumin/globin were decreased significantly,but the level of AST,ALT,GGT,CG,and liver fibrosis marker HA were increased significantly in the patients co-infected with HIV/HCV.Conclusion Patients co-infected with HIV/HCV may aggravate the imbalance of lymphocyte subpopulations,worsen liver injury and occur fibrosis tendency.