摘要:目的 观察人免疫缺陷病毒(HIV)感染者辅助性T细胞(T help cell,Th)17和调节性T细胞(regulatory T cell,Treg)的数量、平衡状态变化及其意义.方法 选取确诊的106例HIV感染者和30例健康体检者(健康对照组),采集静脉血,以流式细胞术检测CD4+T细胞及Th17细胞与Treg细胞百分比,RT-PCR检测HIVRNA病毒载量.结果 HIV感染者CD4+T细胞为13~702个/μL,分为4组,即A组:≤200个/μL,19例;B组:201~350个/μL,32例;C组:351~500个/μL,26例;D组:>500个/μL,29例;上述各组均明显低于健康对照组(798~1 130个/μL)(P<0.05).A、B、C、D组Th17细胞在CD4+T细胞中的百分比分别为(0.73±0.21)%、(1.52±0.33)%、(2.92±0.46)%、(3.74±0.58)%,均低于健康对照组的(4.90±1.43)%(P<0.05);A、B、C、D组及健康对照组Treg细胞在CD4+T细胞中的百分比分别为(9.78±2.15)%、(7.23±1.72)%、(5.69±1.67)%、(4.62±0.97)%、(4.43±0.97)%,除D组与健康对照组之差异无统计学意义(P>0.05),其余组均高于健康对照组(P<0.05).HIV感染者病毒载量水平为(0~5.36)×107拷贝/mL,平均(5.36±1.21)×106拷贝/mL;A、B、C、D组的病毒载量分别为(6.24±1.36)×107拷贝/mL、(4.36±1.02)×1 06拷贝/mL、(5.78±1.67)×104拷贝/mL、(3.54±1.25)×103拷贝/mL,各组间比较,差异有统计学意义(P<0.05),且与CD4+T细胞计数呈负相关.结论 HIV感染导致Th17和CD4+T细胞下降、Th17和Treg细胞失衡,与HIV RNA载量负相关;与疾病进展密切相关.%Objective To evaluate the significance of change in T help cell 17(Th17) and regulatory T cell (Treg) in HIV-infected patients. Methods 106 HIV-infected patients and 30 healthy volunteers were selected. Flow cy-tometry was used to detect the CD4 + T ,Thl7 and Treg cells in peripheral blood. HIV RNA levels in serum were tested by RT-PCR Results CD4+ T cells were 13 - 702/uL, 19 patients were <200/uL (group A), 32 were 201 - 350/uL( group B), 26 were 351 - 500/uL(group C), 29 were >50()/uL(group D); All were significantly lower than (798-1130/uL) in healthy control group(P<0. 05). The percentage of Thl7 cells in CD4 + T cells were (0.73±0.21)%,(1.52 + 0.33)%, (2.92±0.46)% , and (3. 74 + 0.58)% in group A, B,CandD, respectively, which were all lower than (4. 90 ± 1. 43) % of control group(P<(). 05); The percentage of Treg cells in CD4 + T cells were (9. 78±2. 15)%, (7. 23± 1. 72)%, (5.69±1.67)% , and (4. 62±0. 97)% in group A, B,C and D,re-spectively, group A, B and C were higher than (4. 43 ± 0. 97) % of control group(P<0. 05), but group D had no significant difference compared with control group(P>0. 05). HIV RNA levels were (0 - 5. 36)×107copies/mL in HIV-infected patients, the average levels of HIV RNA were (5. 36 ± 1. 21) × 106copies/mL; HIV RNA levels in group A,B,C and D were(6. 24 ± 1. 36) ×107copies/mL, (4. 36 ± 1. 02) × 106 copies/mL, (5. 78 ± 1. 67) ×104 cop-ies/mL,and (3. 54 ± 1. 25) × 103copies/mL ,respectively,there was significant difference between each group(P< 0. 05). HIV RNA levels were negatively correlated with CD4 + T cells count. Conclusion HIV infection can result in the decrease of Thl7 and CD4 + T cells, imbalance of TM7/Treg cells, and negative correlation with HIV RNA levels.