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目的 探究人类免疫缺陷病毒(human immunodeficiency virus, HIV)感染合并冠心病患者外周血CD4+、CD8~+T细胞计数及CD4+/CD8+比值与冠状动脉狭窄程度和不良预后的相关性。方法 回顾性分析2020—2023年昆明市第三人民医院心内科收治的59例HIV感染合并冠心病患者的临床资料，用Gensini评分评估冠状动脉狭窄程度，将患者根据Gensini评分分为轻度组、中度组、重度组，比较3组CD4+、CD8~+T细胞计数及CD4+/CD8+比值。随访并记录HIV感染合并急性冠状动脉综合征患者出院后主要心血管不良事件(majoradversecardiovascularevents,MACE)，将患者分为MACE组和非MACE组，比较2组CD4+、CD8~+T细胞计数及CD4+/CD8+比值。结果 HIV感染合并冠心病患者冠状动脉狭窄重度组CD4~+T细胞计数及CD4+/CD8+比值显著低于轻度组(均P<0.05),MACE组CD4~+T细胞计数显著低于非MACE组(P<0.05)。结论 HIV感染合并冠心病患者的CD4~+T细胞计数、CD4+/CD8+比值越低则冠状动脉狭窄程度越重，CD4~+T细胞计数的降低可能与HIV感染合并急性冠状动脉狭窄患者的MACE事件相关。
Abstract：Objective To investigate the correlation of peripheral blood CD4+ and CD8+ T-cell counts and the CD4+/CD8+ ratio with the degree of coronary artery stenosis and adverse prognosis in patients with human immunodeficiency virus(HIV) and comorbid coronary heart disease. Methods A retrospective analysis was conducted on the clinical data of 59HIV-infected patients with coronary heart disease admitted to the Department of Cardiology at the Third People's Hospital of Kunming from 2020 to 2023. The severity of coronary artery stenosis was assessed using the Gensini score, and patients were classified into mild, moderate, and severe groups based on the Gensini score. The CD4+, CD8+ T cell counts, and CD4+/CD8~+ratios were compared among the 3 groups. Follow-up was performed to record major adverse cardiovascular events(MACE)in HIV-infected patients with acute coronary syndrome after discharge, and patients were divided into MACE and non-MACE groups. The CD4+, CD8+ T cell counts, and CD4+/CD8+ ratios were compared among the 2 groups. Results In patients with HIV infection and comorbid coronary heart disease, the severe coronary stenosis group exhibited significantly lower CD4+ T-cell counts and a lower CD4+/CD8+ ratio compared to the mild stenosis group(P<0.05). Additionally, the MACE group demonstrated significantly lower CD4+ T-cell counts than the non-MACE group(P<0.05). Conclusion Lower CD4+ T-cell counts and CD4+/CD8+ ratios in patients with HIV and comorbid coronary heart disease are associated with a greater degree of coronary artery stenosis. Furthermore, decreased CD4+ T-cell counts may be correlated with the occurrence of MACE in HIV patients with acute coronary stenosis.
[1]王丽,赵青云,杨雪娟,等.云南省245例AIDS患者死亡原因分析[J].传染病信息,2020,33(6):513-516.DOI:10.3969/j.issn.1007-8134.2020.06.005.
[2]Shah ASV,Stelzle D,Lee KK,et al.Global burden of atherosclerotic cardiovascular disease in people living with HIV:systematic review and meta-analysis[J].Circulation,2018,138(11):1100-1112.DOI:10.1161/CIRCULATIONAHA.117.033369.
[3]Saigusa R,Winkels H,Ley K.T cell subsets and functions in atherosclerosis[J].Nat Rev Cardiol,2020,17(7):387-401.DOI:10.1038/s41569-020-0352-5.
[4]Pedicino D,Giglio AF,Ruggio A,et al.Inflammasome,T lymphocytes and innate-adaptive immunity crosstalk:role in cardiovascular disease and therapeutic perspectives[J].Thro mb Haemost,2018,118(8):1352-1369.DOI:10.1055/s-0038-1666860.
[5]So-Armah K,Benjamin LA,Bloomfield GS,et al.HIV and cardiovascular disease[J].Lancet HIV,2020,7(4):e279-e293.DOI:10.1016/S2352-3018(20)30036-9.
[6]Ghamar Talepoor A,Khosropanah S,Doroudchi M.Functional subsets of circulating follicular helper T cells in patients with atherosclerosis[J].Physiol Rep,2020,8(22):e14637.DOI:10.14814/phy2.14637.
[7]Rampidis GP,Benetos G,Benz DC,et al.A guide for Gensini Score calculation[J].Atherosclerosis,2019,287:181-183.DOI:10.1016/j.athero sclerosis.2019.05.012.
[8]马锡慧,肖漓.淋巴细胞亚群成员研究进展[J].中华细胞与干细胞杂志(电子版),2017,7(3):168-172.DOI:10.3877/cma.j.issn.2095-1221.2017.03.009.
[9]Zhou J,Jin S,Ding H,et al.Quantification of subclinical plaque characteristics and perivascular fat using coronary computed tomography angiography(CCTA)among individuals with human immunodeficiency virus(HIV)[J].Quant Imaging Med Surg,2024,14(7):4675-4687.DOI:10.21037/qims-24-79.
[10]Fernandez Soto J,Romero-Jiménez MJ,Alarcon Garcia JC,et al.Predictors of subclinical atherosclerosis in HIV[J].BMC Infect Dis,2023,23(1):17.DOI:10.1186/s12879-022-07976-1.
[11]Kearns A,Gordon J,Burdo TH,et al.HIV-1-associated atherosclerosis:unraveling the missing Link[J].J Am Coll Cardiol,2017,69(25):3084-3098.DOI:10.1016/j.j acc.2017.05.012.
[12]Obare LM,Temu T,Mallal SA,et al.Inflammation in HIV and its impact on atherosclerotic cardiovascular disease[J].Circ Res,2024,134(11):1515-1545.DOI:10.1161/CIRCRESAHA.124.323891.
[13]Sch?fer S,Zernecke A.CD 8+T cells in atherosclerosis[J].Cells,2020,10(1):37.DOI:10.3390/cells10010037.
[14]Boccara F,Mary-Krause M,Potard V,et al.HIV infection and long-term residual cardiovascular risk after acute coronary syndrome[J].J Am Heart Assoc,2020,9(17):e017578.DOI:10.1161/JAHA.119.017578.
[15]Marcus JL,Hurley LB,Prasad A,et al.Recurrence after hospitalization for acute coronary syndrome among HIV-infected and HIV-uninfected individuals[J].HIV Med,2019,20(1):19-26.DOI:10.1111/hiv.12670.
[16]Abubakar M,Irfan U,Abdelkhalek A,et al.Comprehensive quality analysis of conventional and novel biomarkers in diagnosing and predicting prognosis of coronary artery disease,acute coronary syndrome,and heart failure,a comprehensive literature review[J].J Cardiovasc Transl Res,2024,17(6):1258-1285.DOI:10.1007/s12265-024-10540-8.
[17]Souza TMB,Cerqueira AMS Jr,Suerdieck JG,et al.Prognostic value of NT-proBNP versus killip classification in patients with acute coronary syndromes[J].Arq Bras Cardiol,2020,114(4):666-672.DOI:10.36660/abc.20180345.
基本信息:
中图分类号:R541.4;R512.91
引用信息:
[1]高文君,何愿强,沈杰,等.HIV感染合并冠心病患者外周血CD4~+、CD8~+T细胞水平及CD4~+/CD8~+比值与冠状动脉狭窄程度的关系研究[J].传染病信息,2025,38(06):540-543.
基金信息:
昆明市卫生健康委员会卫生科研课题项目（2023-03-04-004）
2025-12-25
2025-12-25