Tuomala R E, Kalish L A, Zorilla C, Fox H, Shearer W, Landay A, Vermund S H, Landesman S, Burns D
Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Obstet Gynecol. 1997 Jun;89(6):967-74. doi: 10.1016/s0029-7844(97)00129-4.
To assess changes in lymphocyte subsets during pregnancy and 1 year postpartum in human immunodeficiency virus (HIV)-infected women.
Changes in CD4+ and CD8+ cell counts, CD4 and CD8 percent, CD4/CD8 ratio, and total lymphocyte count and percent were assessed in each of 226 HIV-infected women followed during pregnancy and 1 year postpartum, and for each of 100 nonpregnant HIV-infected woman during 1 year. Trends over time were compared between pregnant women with and without several covariates. Postpartum changes over a 1-year period were compared to a 1-year period in the nonpregnant cohort.
There was a mean increase of 2.76 per week in the CD4+ cell count during pregnancy (P = .04). No other characteristics changed significantly during pregnancy. The mean CD4+ and CD8+ cell counts, the CD8 percent, and the total lymphocyte count and percent increased immediately postdelivery. During the first postpartum year, there were statistically significant declines in the absolute CD4+ and CD8+ cell counts, the relative CD4 and CD8 percentages, and the total lymphocyte count and percentage. The rate of change for CD4+ and CD8+ counts, but not for CD4 percent, was less during 1 year in the nonpregnant cohort than in the first postpartum year, and the CD8 percent increased in the nonpregnant women. A wide variability in trends of all measurements during pregnancy was seen.
During pregnancy, CD4 and CD8 percentages remain stable. There are no clinically significant changes during pregnancy or postpartum in any lymphocyte parameter we assessed. Postpartum changes in lymphocytes and lymphocyte subsets most likely represent a return to baseline from the physiologic changes of pregnancy and the immediate postpartum period.
评估感染人类免疫缺陷病毒（HIV）的女性在孕期及产后1年淋巴细胞亚群的变化。
对226名感染HIV的女性在孕期及产后1年进行随访，评估其CD4⁺和CD8⁺细胞计数、CD4和CD8百分比、CD4/CD8比值、总淋巴细胞计数及百分比的变化；同时对100名未怀孕的感染HIV女性进行1年的随访并评估上述指标。比较有或无多种协变量的孕妇随时间的变化趋势。将产后1年的变化与未怀孕队列的1年变化进行比较。
孕期CD4⁺细胞计数平均每周增加2.76（P = .04）。孕期无其他特征发生显著变化。分娩后即刻，CD4⁺和CD8⁺细胞计数、CD8百分比、总淋巴细胞计数及百分比均增加。在产后第1年，CD4⁺和CD8⁺细胞绝对计数、CD4和CD8相对百分比、总淋巴细胞计数及百分比均出现统计学显著下降。未怀孕队列1年中CD4⁺和CD8⁺计数的变化率低于产后第1年，但CD4百分比变化率无此差异，且未怀孕女性的CD8百分比增加。孕期所有测量指标的变化趋势存在很大差异。
孕期CD4和CD8百分比保持稳定。我们评估的任何淋巴细胞参数在孕期或产后均无临床显著变化。淋巴细胞及淋巴细胞亚群的产后变化很可能是从孕期及产后即刻的生理变化恢复到基线水平。
