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目的分析艾滋病病毒(HIV)感染者的CD+4T淋巴细胞(简称CD4细胞)计数,以及血浆和尿液中人巨细胞病毒(HCMV)脱氧核糖酸(DNA)检出率的差异性及其临床意义。方法 2012年7月至2013年7月间,对杭州市西溪医院住院的202例HIV感染者的血浆和尿液标本检测HCMV核酸,分析两种类型的标本HCMV-DNA检出率的差异性,同时观察CD4细胞计数与HCMV-DNA表达的关系并分析其临床意义。结果 202份血浆中HCMV-DNA阳性检出率为29.70%(60份),202份尿液中HCMV-DNA检出率为47.03%(95份),两种类型标本HCMV-DNA检出率差异有统计学意义(χ2=5.79,P<0.05)。不同CD4细胞计数的病人,其HCMV-DNA检出率也存在差异。在85例CD4细胞计数>250个/μL组病人的尿液、血液中HCMV-DNA检出率分别为20.00%、2.35%;75例CD4细胞计数101~250个/μL组病人的尿液、血液中HCMV-DNA检出率分别为61.33%、44.00%;42例CD4细胞计数<100个/μL组病人的尿液、血液中,HCMV-DNA检出率分别为76.19%、59.52%。随着CD4细胞计数的下降,尿液、血液中的HCMV-DNA检出率逐渐升高,各组间比较差异有统计学意义(χ2=15.25,P<0.05)。结论 HIV感染者血浆、尿液HCMV-DNA检出率存在差异,外周血CD4细胞计数越低越易发生HCMV感染。
Objective To analyze the count of CD + 4T lymphocytes (CD4 cells) in HIV-infected persons and the difference of detection rate of human cytomegalovirus (HCMV) deoxyribonucleic acid (DNA) in plasma and urine and its clinical significance. Methods From July 2012 to July 2013, HCMV nucleic acid was detected in plasma and urine samples of 202 HIV-infected patients in Xixi Hospital of Hangzhou City. The differences of HCMV-DNA detection rates between the two types of samples were analyzed. At the same time observe the relationship between CD4 cell count and HCMV-DNA expression and analyze its clinical significance. Results The positive rate of HCMV-DNA in 202 plasma samples was 29.70% (60 samples), and the detection rate of HCMV-DNA in 202 samples was 47.03% (95 samples). The detection rates of HCMV-DNA in two types of samples were different There was statistical significance (χ2 = 5.79, P <0.05). Patients with different CD4 cell counts also have differences in HCMV-DNA detection rates. The detection rates of HCMV-DNA in urine and blood of 85 patients with CD4 count> 250 cells / μL were 20.00% and 2.35%, respectively. The urine of 75 patients with CD4 counts of 101-250 cells / μL, The detection rates of HCMV-DNA in blood were 61.33% and 44.00% respectively. The detection rates of HCMV-DNA in urine and blood of 42 patients with CD4 counts <100 / μL were 76.19% and 59.52% respectively. With the decrease of CD4 cell count, the detection rate of HCMV-DNA in urine and blood increased gradually, with significant difference between the groups (χ2 = 15.25, P <0.05). Conclusion The detection rates of HCMV-DNA in plasma and urine of HIV-infected individuals are different. HCMV infection is more likely to occur when the CD4 count in peripheral blood is lower.