艾滋病患者胃黏膜与外周血中人类免疫缺陷病毒感染和CD4~+T淋巴细胞数量的区室性差异的探讨

目的 探讨AIDS患者胃黏膜与外周血中HIV感染和CD4~+T淋巴细胞数量的区室性差异.方法 选取AIDS患者35例,对照组为HIV抗体阴性者10例,均进行胃镜检查并收集外周血.PCR法制备地高辛标记HIV-1长末端重复序列(LTR)、gag基因的双链cDNA探针,核酸原位杂交方法观察胃黏膜组织冰冻切片和外周血单个核细胞(PBMC)涂片H1V感染情况,免疫组织化学方法检测CD41T淋巴细胞,数据结果行t检验.结果 AIDS未治疗组胃黏膜中HIV阳性率为(1.67±1.48)%,PBMC中为(19.37±9.23)%.AIDS未治疗组与高效抗反转录病毒治疗(HAART)组各组间的胃黏膜HIV阳性率差异尤统计学意义(t=-0.996,t=-0.794,t=-0.461;P＞0.05).PBMC涂片中,治疗1～4年组HIV阳性率为(4.25±3.47)%,明显低于未治疗组的(19.37±9.23)%(t=3.000,P＜0.05).AIDS未治疗组胃黏膜单个核细胞(MMC)中CD4+T淋巴细胞阳性率为(12.53±8.14)%,PBMC中CD4+T淋巴细胞阳性率为(19.00±9.55)%,HAART1～4年组胃黏膜MMC中CD4~+T淋巴细胞计数为(37.44±18.00)%,仍低于对照组的(50.35±3.41)%(t=-4.620,P＜0.01),但PBMC中CD4+T淋巴细胞计数与对照组比较,差异无统计学意义(t=-2.094,P＞0.05).结论 胃黏膜与外周血中HIV感染和CD4~+T淋巴细胞数量存在区室性差异.

The investigation of compartmentalization of human immunodeficiency virus infection and CD4~+T lymphocytes between gastric mucosa and peripheral blood from patients with acquired immune deficiency syndrome

Objective To investigate the compartmentalization of human immunodeficiency virus (HIV)infection and CD4~+ T lymphocytes between gastric mueosa and peripheral blood from patients with acquired immune deficiency syndrome(AIDS).Methods Thirty-five AIDS patients and 10 HIV seronegative subjects were enrolled in this study.The gastric mucosal biopsies were done by gastroscope and peripheral blood samples were collected.The digoxin labeled HIV-1 double-stranded cDNA probes for the long terminal repeat(LTR)and gag gene of HIV-1 genome were prepared by polymerase chain reaction(PCR).In situ hybridization was used to detect HIV infection in gastric mucosal tissues and peripheral blood mononuclear cells(PBMC)of AIDS patients.CD4~+ T lymphocytes were determined by immunohistochemistry method.The data were analyzed using t test.Results HIV positive rates were(1.67±1.48)% in gastric mucosa and(19.37±9.23)% in PBMC of AIDS patients who had not received highly active antiretroviral therapy(HAART).The HIV positive rates in gastric mucosa were not significantly different between AIDS patients without treatment and those treated with HAART(t=-0.996,t=-0.794,t=-0.461;P＞0.05).HIV positive rate on PBMC film preparation in patients who had received HAART for 1-4 years was (4.25±3.47)%,which was significantly lower than untreated group(19.37±9.23)%](t=3.000,P＜0.05).The positive rate of CD4~+ T lymphocytes was(12.53±8.14)% in gastric mucosal mononuclear cells(MMC)and(19.00±9.55)% in PBMC of AIDS patient who had not received HAART.Even after received HAART for 1-4 years,the positive rate of CD4 ~+ T lymphocytes in MMC were(37.44±18.00)%,which was still lower than control group(50.35±3.41)%](t=-4.620,P＜0.01);while the positive rate of CD4~+ T lymphocyte in PBMC was similar with that of control group(t=-2.094,P＞0.05).Conclusion The compartmentalization of HIV infection and CD4~+ T lymphocyte counts exists between gastric mucosa and peripheral blood from AIDS patients.