内科

目的比较艾滋病单纯合并马尔尼菲篮状菌（TM）或乙型肝炎病毒（HBV）或丙型肝炎病毒（HCV）感染的黄疸患者的肝功能与T淋巴细胞亚群，指导患者的临床治疗。方法选取2015年1月1日至2017年12月31日在南宁市第四人民医院艾滋病科住院治疗的艾滋病黄疸患者318例为研究对象，根据患者合并TM或HBV或HCV感染的情况，分为艾滋病合并TM黄疸组（128例）、艾滋病合并HBV黄疸组（126例）、艾滋病合并HCV黄疸组（64例），比较三组患者的肝功能、T淋巴细胞亚群。结果三组患者的丙氨酸氨基转移酶、门冬氨酸氨基转移酶、总胆红素水平比较差异无统计学意义（P＞0.05）；三组患者的直接胆红素、间接胆红素水平比较，差异有统计学意义（P＜0.05）；三组患者的CD3+T、CD4+T、CD8+T淋巴细胞水平以及CD4+/CD8+比较差异有统计学意义，艾滋病合并TM黄疸组患者的上述指标水平均显著低于艾滋病合并HBV黄疸组和艾滋病合并HCV黄疸组患者，差异有统计学意义（P＜0.05）。结论艾滋病单纯合并HBV或HCV或TM感染的黄疸患者的肝功能受损的严重程度相似，而艾滋病合并TM感染的黄疸患者的免疫功能受损较严重，临床治疗过程中要加以重视。

ObjectiveTo compare the liver function and T lymphocyte subsets of jaundice patients infected with AIDS combined with talaromyces marneffei (TM) or hepatitis B virus (HBV) or hepatitis C virus (HCV), and to guide the clinical treatment of patients. MethodsA total of 318 patients with AIDS and jaundice who were hospitalized in the Department of HIV/AIDS of the Nanning Fourth People′s Hospital from January 1st, 2015 to December 31th, 2017 were selected as the research objects, and they were divided into AIDS combined with TM jaundice group (128 cases), AIDS combined with HBV jaundice group (126 cases), and AIDS combined with HCV jaundice group (64 cases) in accordance with the infectious condition of patients combined with TM or HBV or HCV. The liver function and T lymphocyte subsets of the three groups were compared. ResultsThere were no statistically significant differences in the levels of alanine aminotransferase, aspartate aminotransferase, and total bilirubin between the three groups (P＞0.05). There were statistically significant differences in the levels of direct bilirubin and indirect bilirubin between the three groups (P＜0.05). There were statistically significant differences in the levels of CD3+ T, CD4+ T, CD8+ T lymphocytes and CD4+/CD8+ between the three groups. The levels of the indicators mentioned above in the AIDS combined with TM jaundice group were significantly lower than those in the AIDS combined with HBV jaundice group and the AIDS combined with HCV jaundice group, with statistically significant differences (P＜0.05). ConclusionThe severity of liver function impairment in jaundice patients with simple AIDS combined with HBV or HCV or TM infection is similar, while the immune function of jaundice patients with AIDS combined with TM infection is more severely impaired, and thus the attention should be paid to the clinical treatment.