HIV感染/AIDS患者相关支原体感染与免疫指标及炎症因子水平的关联性
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摘要
目的分析人类免疫缺陷病毒(HIV)感染/获得性免疫缺陷综合征(AIDS)患者相关支原体感染与免疫指标、炎症因子水平的关联性。方法选取2015年1月-2017年12月的102例HIV感染/AIDS患者作为研究对象,对其尿液样本中的生殖支原体、梨支原体、发酵支原体等相关支原体的感染情况、外周血CD_4~+T淋巴细胞计数、血清白细胞介素-2(IL-2)、白细胞介素-4(IL-4)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平进行检测和分析。结果:共有67例患者尿样中检出支原体核酸,感染率为65.69%;其中,检出生殖支原体感染23例、检出梨支原体感染15例,检出发酵支原体感染29例,感染率分别为22.55%、14.71%、28.43%,差异无统计学意义(P=0.059);HIV感染患者与AIDS患者三种支原体感染率的差异均无统计学意义;CD_4~+T淋巴细胞水平<500个/μL患者的三种支原体感染率高于CD_4~+T淋巴细胞水平≥500个/μL的患者(P<0.05);合并支原体感染患者的血清IL-2、TNF-α水平均低于未合并支原体感染患者,血清IL-4水平高于未合并支原体感染患者(P <0.05)。结论 HIV感染/AIDS患者具有较高的致病性支原体感染率,免疫功能较差患者的支原体感染率较高,支原体感染患者可表现为炎症因子的低表达,但尚不能认为支原体感染能够影响患者的免疫功能。
OBJECTIVE To analyze the association between the AIDS-related Mycoplasma infections and the immunes indicators and the inflammatory factors in the patients with human immunodeficiency virus(HIV)infection/acquired immunodeficiency syndrome(AIDS).METHODS 102 cases of patients with HIV infection/AIDS from Jan.2015 to Dec.2017 were selected as the research subjects.The infection conditions of AIDS-related Mycoplasma such as Mycoplasma genitalium,Mycoplasma pirum,Mycoplasma fermentans in the urine samples,the peripheral blood CD_4~+T lymphocyte percentage,the serum interleukin-2(IL-2),interleukin-4(IL-4),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)levels of the patients were detected and analyzed.RESULTS A total of 67 cases of patients were detected with Mycoplasma nucleic acid in the urine,the infection rate was65.69%,among them,23 cases were detected as M genitaliuminfections,15 cases were detected as M piruminfections,29 cases were detected as M fermentans infections,with infection rates of 22.55%,14.71%and 28.43%respectively,the difference was not significant(P=0.059).There were no significant differences in the infection rates of the three kinds of Mycoplasma between HIV infected patients and AIDS patients(P=0.070,0.974,0.109).The infection rates of these Mycoplasma of the patients with CD_4~+T lymphocyte level of<500/μL were significantly higher than those with CD_4~+T lymphocyte level of≥500/μL(P<0.05).The serum IL-2,TNF-αlevels of the patients complicated with Mycoplasmainfections were significantly lower than those of the patients without Mycoplasmainfections,whereas the serum IL-4 level was significantly higher than that of the patients without Mycoplasmainfections(P<0.05).CONCLUSIONThe patients with HIV infection/AIDS have high infection rates of pathogenic mycoplasma.The patients with poor immune function may have high infection rates of Mycoplasma.The patients with Mycoplasma infections show low expression of inflammatory cytokines,but we can still not conclude that Mycoplasmainfections can affect the immune functions of the patients.
OBJECTIVE To analyze the association between the AIDS-related Mycoplasma infections and the immunes indicators and the inflammatory factors in the patients with human immunodeficiency virus(HIV)infection/acquired immunodeficiency syndrome(AIDS).METHODS 102 cases of patients with HIV infection/AIDS from Jan.2015 to Dec.2017 were selected as the research subjects.The infection conditions of AIDS-related Mycoplasma such as Mycoplasma genitalium,Mycoplasma pirum,Mycoplasma fermentans in the urine samples,the peripheral blood CD_4~+T lymphocyte percentage,the serum interleukin-2(IL-2),interleukin-4(IL-4),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)levels of the patients were detected and analyzed.RESULTS A total of 67 cases of patients were detected with Mycoplasma nucleic acid in the urine,the infection rate was65.69%,among them,23 cases were detected as M genitaliuminfections,15 cases were detected as M piruminfections,29 cases were detected as M fermentans infections,with infection rates of 22.55%,14.71%and 28.43%respectively,the difference was not significant(P=0.059).There were no significant differences in the infection rates of the three kinds of Mycoplasma between HIV infected patients and AIDS patients(P=0.070,0.974,0.109).The infection rates of these Mycoplasma of the patients with CD_4~+T lymphocyte level of<500/μL were significantly higher than those with CD_4~+T lymphocyte level of≥500/μL(P<0.05).The serum IL-2,TNF-αlevels of the patients complicated with Mycoplasmainfections were significantly lower than those of the patients without Mycoplasmainfections,whereas the serum IL-4 level was significantly higher than that of the patients without Mycoplasmainfections(P<0.05).CONCLUSIONThe patients with HIV infection/AIDS have high infection rates of pathogenic mycoplasma.The patients with poor immune function may have high infection rates of Mycoplasma.The patients with Mycoplasma infections show low expression of inflammatory cytokines,but we can still not conclude that Mycoplasmainfections can affect the immune functions of the patients.
引文
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[17]马雪婷,李娅.新发现艾滋病病毒感染者/艾滋病患者(HIV/AIDS)T淋巴细胞亚群分析[J].昆明医科大学学报,2017,38(11):112-117.
[18]贠赟,付立.开封市艾滋病患者CD4+T淋巴细胞检测结果及影响因素分析[J].现代医药卫生,2018,34(15):2374-2376.
[19]刘玄华,朱秋映,苏锦明,等.广西壮族自治区2008-2015年艾滋病病毒感染者基线CD4+T淋巴细胞计数水平对抗病毒治疗脱失的影响[J].中华流行病学杂志,2018,25(9):1216-1221.
[20]李世福,高良敏,蔡英,等.未治疗HIV/AIDS中CD4+T淋巴细胞计数与机会性感染的相关性分析[J].中国皮肤性病学杂志,2017,31(3):267-272.
[21]韩晶,汤后林,李健,等.2011年新报告的艾滋病病毒感染者接受抗病毒治疗前CD4+T淋巴细胞计数自然变化情况分析[J].疾病监测,2017,26(6):472-476.
[22]马灿业,李宝金,廖坚松,等.艾滋病合并乙型肝炎后肝硬化患者血清生化指标及T淋巴细胞亚群水平变化的临床价值[J].广州医科大学学报,2017,45(2):36-38.
[2]Kojovic B,Tariman JD.Decision AIDS:assisting patients with multiple myeloma and caregivers with treatment decision making[J].Clin J Oncol Nurs,2017,21(6):660-664.
[3]朱博文,倪蕴嘉,庄勋.AIDS疫情估计方法研究进展[J].中国公共卫生,2017,33(6):1028-1032.
[4]Napierala Mavedzenge S,Muller EE,Lewis DA,et al.Mycoplasma genitaliumis associated with increased genital HIVtype 1RNA in Zimbabwean women[J].J Infect Dis,2015,211(9):1388-1398.
[5]Dehon PM,Hagensee ME,Sutton KJ,et al.Histological evidence of chronic Mycoplasma genitalium-induced cervicitis in HIV-infected women:a retrospective cohort study[J].J Infect Dis,2016,213(11):1828-1835.
[6]Hakre S,Casimier RO,Danboise BA,et al.Enhanced sexually transmitted infection screening for Mycoplasma genitaliumin human immunodeficiency virus-infected US Air Force personnel[J].Clin Infect Dis,2017,65(9):1585-1588.
[7]卫生部传染病标准专业委员会.艾滋病和艾滋病病毒感染诊断标准[J].中国艾滋病性病,2012,18(4):272-274.
[8]郑武,笪琴,张薇,等.湖北省接受艾滋病HAART患者CD4+T淋巴细胞变化趋势及影响因素[J].实用预防医学,2018,25(11):1325-1328.
[9]韦明,江洪,罗春英,等.AIDS宫颈分泌物淋病奈瑟菌、解脲支原体、沙眼衣原体检测及与CD4+T细胞计数和HIV载量的关系[J].实用妇产科杂志,2016,23(12):937-939.
[10]Bernard C,Balestre E,Coffie PA,et al.Aging with HIV:what effect on mortality and loss to follow-up in the course of antiretroviral therapy?The IeDEA West Africa Cohort Collaboration[J].HIV AIDS(Auckl),2018,10:239-252.
[11]彭忠秀,李晶,汤恋花,等.HIV合并HBV感染对患者免疫功能和肝功能的影响[J].深圳中西医结合杂志,2016,22(16):3-5.
[12]杨立刚.生殖支原体致病性及其感染的治疗进展[J].国际皮肤性病学杂志,2017,43(6):374-376.
[13]Read TRH,Jensen JS,Fairley CK,et al.Use of pristinamycin for macrolide-resistant Mycoplasma genitaliuminfection[J].Emerg Infect Dis,2018,24(2):328-335.
[14]Slifirski JB,Vodstrcil LA,Fairley CK,et al.Mycoplasma genitaliuminfection in adults reporting sexual contact with infected partners,Australia,2008-2016[J].Emerg Infect Dis,2017,23(11):1826-1833.
[15]Peter C,Alec M,Bigoni J,et al.Update on Mycoplasma genitalium among women[J].Rev Med Suisse,2018,14(624):1893-1897.
[16]Braam JF,van Marm S,Severs TT,et al.Sensitive and specific assay for the simultaneous detection of Mycoplasma genitaliumand macrolide resistance-associated mutations[J].Eur JClin Microbiol Infect Dis,2018,37(11):2137-2144.
[17]马雪婷,李娅.新发现艾滋病病毒感染者/艾滋病患者(HIV/AIDS)T淋巴细胞亚群分析[J].昆明医科大学学报,2017,38(11):112-117.
[18]贠赟,付立.开封市艾滋病患者CD4+T淋巴细胞检测结果及影响因素分析[J].现代医药卫生,2018,34(15):2374-2376.
[19]刘玄华,朱秋映,苏锦明,等.广西壮族自治区2008-2015年艾滋病病毒感染者基线CD4+T淋巴细胞计数水平对抗病毒治疗脱失的影响[J].中华流行病学杂志,2018,25(9):1216-1221.
[20]李世福,高良敏,蔡英,等.未治疗HIV/AIDS中CD4+T淋巴细胞计数与机会性感染的相关性分析[J].中国皮肤性病学杂志,2017,31(3):267-272.
[21]韩晶,汤后林,李健,等.2011年新报告的艾滋病病毒感染者接受抗病毒治疗前CD4+T淋巴细胞计数自然变化情况分析[J].疾病监测,2017,26(6):472-476.
[22]马灿业,李宝金,廖坚松,等.艾滋病合并乙型肝炎后肝硬化患者血清生化指标及T淋巴细胞亚群水平变化的临床价值[J].广州医科大学学报,2017,45(2):36-38.