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Thụ thể yếu tố hoại tử khối u tan (sTNF-Rs) ở người tiêm chích ma túy nhiễm HIV-1: Sự thay đổi trong mức độ vòng tuần hoàn của thụ thể loại II và khả năng sống sót của bệnh nhân AIDS
Tóm tắt
Nghiên cứu này trên những người tiêm chích ma túy tĩnh mạch (IVDUs) đã khảo sát sự khác biệt về nồng độ thụ thể yếu tố hoại tử khối u tan loại I và II (sTNFR-I và II) trong huyết thanh giữa IVDUs nhiễm HIV-1 và nhóm đối chứng. Nghiên cứu này cũng đã điều tra xem sự thay đổi của nồng độ sTNFRs có ảnh hưởng đến nguy cơ tử vong ở bệnh nhân AIDS hay không. Một nghiên cứu cắt ngang với 54 đối tượng có AIDS, 47 IVDUs dương tính với HIV, 47 IVDUs âm tính với HIV, và 21 người khỏe mạnh cho thấy rằng nồng độ sTNFRs tăng từ nhóm đối chứng khỏe mạnh đến bệnh nhân AIDS thông qua nhóm âm tính với HIV và dương tính với HIV (p < 0.01). Tuy nhiên, nồng độ sTNFR-I được cho là tương tự ở IVDUs âm tính với HIV và nhóm đối chứng khỏe mạnh. Trong nghiên cứu theo chiều dọc, nồng độ sTNFRs trong huyết thanh được xác định gần với chẩn đoán AIDS ở 21 IVDUs và 1 năm sau đó (bắt đầu cho nghiên cứu tồn tại). Phân tích hồi quy Cox tỷ lệ nguy cơ đã được thực hiện để đánh giá giá trị tiên lượng của sự thay đổi phần trăm mức sTNFR một mình và kết hợp với các phân nhóm lympho T, HIV-p24 antigenemia và các nhiễm trùng cơ hội cho tử vong trong vòng 240 ngày. Mô hình Cox đơn biến và đa biến cho các biến phân loại theo phương trình trung bình cho thấy sự gia tăng của sTNFR-II ít nhất 30% là yếu tố dự đoán duy nhất có ý nghĩa đối với tử vong: nguy cơ tương đối thô 3.69, p = 0.03; nguy cơ tương đối điều chỉnh 5.67, p = 0.02. Thời gian sống trung bình là 126 ngày ở 11 bệnh nhân có mức sTNFR-II tăng ít nhất 30%, và 176 ngày ở 10 bệnh nhân có sự thay đổi ít hơn trong sTNFR-II (p = 0.02). Kết luận: Nồng độ sTNFRs cao hơn ở IVDUs so với nhóm đối chứng khỏe mạnh và cao nhất ở bệnh nhân AIDS. Khả năng sống sót của bệnh nhân AIDS liên quan đến sự biến thiên trong nồng độ sTNFR-II.
Từ khóa
#sTNF-R #HIV-1 #người tiêm chích ma túy #AIDS #yếu tố hoại tử khối u #tiên lượng sống sótTài liệu tham khảo
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