摘要
目的探究艾滋病患者血清可溶性白细胞分化抗原14亚型(sCD14-ST)、CXC趋化因子基序配体13(CXCL13)、白介素-10(IL-10)的表达情况,分析血清sCD14-ST、CXCL13、IL-10对艾滋病的诊断和预后价值。方法选取2021年1月至2023年12月自贡市第一人民医院收治的150例艾滋病患者作为研究对象,设为观察组,根据随访结果分为预后良好组(n=89)与预后不良组(n=61)。另选取同期健康体检者150例设为对照组。收集并比较观察组与对照组的临床资料。采用Spearman分析血清sCD14-ST、CXCL13、IL-10与CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)的相关性。采用Logistic回归分析艾滋病患者预后不良的影响因素。采用受试者工作特征(ROC)曲线分析血清sCD14-ST、CXCL13、IL-10对艾滋病的诊断和预后价值。结果观察组CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)低于对照组,sCD14-ST、CXCL13、IL-10高于对照组(P<0.05)。血清sCD14-ST、CXCL13、IL-10与CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)均呈负相关(P<0.05)。血清sCD14-ST、CXCL13、IL-10联合诊断艾滋病的曲线下面积(AUC)高于血清sCD14-ST、CXCL13、IL-10单独诊断(Z_(联合-sCD14-ST)=4.883、Z_(联合-CXCL13)=4.622、Z_(联合-IL-10)=5.863,P<0.05)。预后不良组的CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、血小板计数、中性粒细胞百分比、血清白蛋白水平均低于预后良好组,有生殖器疱疹、高人类免疫缺陷病毒(HIV)载量患者所占比例及白细胞计数、sCD14-ST、CXCL13、IL-10水平高于预后良好组(P<0.05)。高HIV载量、低水平CD4^(+)、低水平血清白蛋白、高水平sCD14-ST、高水平CXCL13、高水平IL-10是艾滋病患者预后不良的危险因素(P<0.05)。血清sCD14-ST、CXCL13、IL-10联合预测艾滋病患者预后不良的AUC高于血清sCD14-ST、CXCL13、IL-10单独预测(Z_(联合-sCD14-ST)=3.027、Z_(联合-CXCL13)=3.127、Z_(联合-IL-10)=2.841,P<0.05)。结论艾滋病患者血清sCD14-ST、CXCL13、IL-10水平较高,是患者预后不良的危险因素,联合检测可更有效地诊断艾滋病和预测患者预后。
Objective To investigate the expression of serum soluble leukocyte differentiation antigen subtype 14(sCD14-ST),C-X-C motif chemokine ligand 13(CXCL13),and interleukin-10(IL-10)in acquired immunodeficiency syndrome(AIDS)patients,and to analyze the diagnostic and prognostic value of serum sCD14-ST,CXCL13,and IL-10 in AIDS.Methods A total of 150 AIDS patients admitted to Zigong First People′s Hospital from January 2021 to December 2023 were selected as study objects and set as observation group.According to the follow-up results,they were grouped into a good prognosis group(n=89)and a poor prognosis group(n=61).Additionally,150 people received health examination during the same period were regarded as control group.Clinical data of the observation group and the control group were collected and compared.Spearman analysis was applied to analyze the correlation between serum sCD14-ST,CXCL13,and IL-10 with CD4^(+),CD8^(+),and CD4^(+)/CD8^(+).Logistic regression analysis was used to analyze the factors influencing the poor prognosis of AIDS patients.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic and prognostic value of serum sCD14-ST,CXCL13 and IL-10 in AIDS.Results The CD4^(+),CD8^(+),and CD4^(+)/CD8^(+)in the observation group were lower than those in the control group,while sCD14-ST,CXCL13,and IL-10 were higher than those in the control group(P<0.05).Serum sCD14-ST,CXCL13,and IL-10 were all negatively correlated with CD4^(+),CD8^(+),and CD4^(+)/CD8^(+)(P<0.05).The area under the curve(AUC)of serum sCD14-ST,CXCL13 and IL-10 in combination in the diagnosis of AIDS was higher than that of serum sCD14-ST,CXCL13 and IL-10 alone(Z_(combination-sCD14-ST)=4.883,Z_(combination-CXCL13)=4.622,Z_(combination-IL-10)=5.863,P<0.05).The CD4^(+),CD8^(+),CD4^(+)/CD8^(+),platelet count,neutrophil percentage,and serum albumin level in the poor prognosis group were lower than those in the good prognosis group,while having genital herpes,the proportion of patients with high human immunodeficiency virus(HIV)load,white blood cell count,sCD14-ST,CXCL13,and IL-10 levels were higher than those in the good prognosis group(P<0.05).High HIV load,low level of CD4^(+),low level of serum albumin,high level of sCD14-ST,high level of CXCL13,and high level of IL-10 were risk factors for the poor prognosis of AIDS patients(P<0.05).The combined prediction of serum sCD14-ST,CXCL13 and IL-10 for the poor prognosis of AIDS patients was higher than that of serum sCD14-ST,CXCL13 and IL-10 alone(Z_(combination-sCD14-ST)=3.027,Z_(combination-CXCL13)=3.127,Z_(combination-IL-10)=2.841,P<0.05).Conclusions The levels of serum sCD14-ST,CXCL13 and IL-10 are relatively high in AIDS patients,and they are risk factors for the poor prognosis of patients.Combined detection can diagnose AIDS and predict the prognosis of patients more effectively.
作者
邓薇
游春芳
唐静
DENG Wei;YOU Chunfang;TANG Jing(Department of Infectious Diseases,Zigong First People′s Hospital,Zigong 643000,Sichuan,China)
出处
《中国性科学》
2025年第6期144-150,共7页
Chinese Journal of Human Sexuality
基金
自贡市重点科技计划项目(2021ZC11)。
关键词
艾滋病
可溶性白细胞分化抗原14亚型
CXC趋化因子基序配体13
白介素-10
诊断
预后
Acquired immunodeficiency syndrome
Soluble leukocyte differentiation antigen subtype 14
C-X-C motif chemokine ligand 13
Interleukin-10
Diagnosis
Prognosis
作者简介
通讯作者:游春芳,E-mail:youchunfang2011@163.com。
