HIV/AIDS合并结核感染患者贫血情况及其与CD4⁺ T淋巴细胞计数和BMI指数相关性分析

Anemia in HIV/AIDS Patients with Tuberculosis Infection and Its Correlation with CD4⁺ T Lymphocyte Count and BMI Index

摘要: 目的：了解HIV/AIDS合并结核感染患者贫血情况，并与CD4⁺ T淋巴细胞计数水平及BMI指数相关性进行分析。方法：回顾性分析某传染病医院2014年1月~2023年12月期间确诊为HIV/AIDS合并结核感染的患者289例，收集其临床资料及实验室检测指标进行贫血相关性分析，选取同期HIV/AIDS患者289例进行对照研究，数据分析采用SPSS 23.0进行。结果：共收集HIV/AIDS-TB患者289例，以男性为主，年龄集中在31~50岁之间，大部分患者已婚，职业以农民为主，CD4⁺ T淋巴细胞计数 ≤ 200患者占82%，BMI指数 < 18.5患者占38.1%。两组患者相比，红细胞相关指数中RBC、HGB、HCT、MCHC差异有统计学意义(P < 0.05)，且HIV/AIDS合并结核感染组中的RBC、HGB、HCT、MCHC计数更低。HIV/AIDS合并结核感染组贫血患病率为82% (237/289)，远高于HIV/AIDS单纯感染组9.7% (28/289)，两组差异有统计学意义(P < 0.001)，贫血类型均以正细胞性贫血为主。HIV/AIDS合并结核感染患者CD4⁺ T淋巴细胞计数 ≤ 200个/μL贫血患病率为72.2% (66/171)，且CD4 ≤ 200个/μL患者的贫血患病风险为CD4 > 200个/μL的患者的5.83倍；BMI指数 < 18.5患者的贫血患病率为80% (88/110)，而BMI指数 ≥ 18.5患者贫血患病率为62.6% (112/179)，且BMI指数 < 18.5患者的贫血患病风险是BMI指数 ≥ 18.5患者的1.92倍。结论：合并结核的HIV/AIDS患者贫血发生率较高，且与较低的CD4⁺ T淋巴细胞计数和BMI指数相关，需要对这一人群进行有针对性的干预。

Abstract: Objective: To investigate the status of anemia in HIV/AIDS patients with tuberculosis infection, and to analyze its correlation with CD4⁺ T lymphocyte count and BMI. Method: A retrospective analysis was performed on 289 patients diagnosed with HIV/AIDS combined with tuberculosis infection in an infectious disease hospital from January 2014 to December 2023. The clinical data and laboratory test indicators were collected for anemia correlation analysis, and 289 patients with HIV/AIDS during the same period were selected for control study. SPSS 23.0 was used for data analysis. Results: A total of 289 HIV/AIDS-TB patients were collected, mainly male, aged between 31 and 50 years old, most of the patients were married, mainly farmers, patients with CD4⁺ T lymphocyte count ≤ 200 accounted for 82%, and patients with BMI < 18.5 accounted for 38.1%. There were statistically significant differences in RBC, HGB, HCT and MCHC in the RBC correlation index between the two groups (P < 0.05), and the RBC, HGB, HCT and MCHC counts in the HIV/AIDS group combined with tuberculosis infection were lower. The prevalence rate of anemia in HIV/AIDS combined with tuberculosis infection was 82% (237/289), much higher than that in HIV/AIDS simple infection group (9.7% (28/289), the difference between the two groups was statistically significant (P < 0.001), and the types of anemia were mainly positive cell anemia. The prevalence rate of anemia in HIV/AIDS patients with TB infection was 72.2% (66/171), and the risk of anemia in patients with CD4⁺ T lymphocyte count ≤ 200/μL was 5.83 times that of patients with CD4 > 200/μL. The prevalence of anemia was 80% (88/110) in patients with a BMI < 18.5, compared with 62.6% (112/179) in patients with a BMI ≥ 18.5, and the risk of anemia was 1.92 times higher in patients with a BMI < 18.5. Conclusions: The higher incidence of anemia in HIV/AIDS patients with TB is associated with lower CD4⁺ T lymphocyte count and BMI, and targeted intervention is needed in this population.