摘要目的：了解艾滋病急性期患者血浆可溶性 CD14（sCD14）水平变化对病程进展的影响。方法纳入2007年6月至2010年6月在北京佑安医院随访的 HIV 急性期感染者41例，其中感染HIV 3年后 CD4＋ T 淋巴细胞计数≥350／μL 的急性期感染者20例，感染 HIV 3年后 CD4＋ T 淋巴细胞计数＜350／μL 的急性期感染者21例；另取健康献血员20名作为对照组。ELISA 法检测健康对照组和感染 HIV 1～30、31～90、91～180和181～360 d 时患者血浆 sCD14水平。两组间均数比较采用 t 检验，多组间均数两两比较采用 ANOVA 模块进行分析。结果健康对照组血浆 sCD14水平为（1654±904）μg／L。感染 HIV 3年后，CD4＋ T 淋巴细胞计数＜350／μL 组血浆 sCD14为（4214±2635）μg／L，高于 CD4＋ T 淋巴细胞计数≥350／μL 组的（2275±1457）μg／L（t ＝－5．41，P ＜0．01）。HIV 感染181～360 d 时血浆 sCD14水平为（4485±2779）μg／L，较1～30 d 时的（2577±1635）μg／L 明显升高，差异有统计学意义（t ＝－3．39，P ＜0．05）。血浆 sCD14水平与病毒载量呈正相关（r ＝0．35，P ＝0．0001），与 CD4＋ T 淋巴细胞计数呈负相关（r＝－0．28，P ＝0．001）。结论 HIV 急性期感染人群中血浆 sCD14明显升高，并有随感染时间延长而升高的趋势。急性期血浆中 sCD14水平变化可能与艾滋病病程进展密切相关。

abstractsObjective To investigate the correlation between plasma soluble CD14 (sCD14)level and disease progression in patients with acute phase of acquired immunodeficiency syndrome (AIDS). Methods Forty-one human immunodeficiency virus (HIV)-infected patients were followed up from June 2007 to June 2010 in Beijing You′an Hospital,including 20 patients with CD4 + T lymphocyte counts more than 350/μL,and 21 less than 350/μL after 3 years of HIV infection.Twenty healthy blood donors were recruited as controls.Enzyme-linked immunosorbent assay (ELISA)was employed to test the plasma sCD14 level of healthy controls and patients infected with HIV at 1 -30 d,31 -90 d,91 - 180 d and 181 -360 d.Student t test was used to compare the means between two groups.ANOVA analysis was used to compare the means among more than two groups.Results The mean plasma sCD14 level in control group was (1 654±904)μg/L.Three years after HIV infection,the sCD14 level of patients with CD4 + T lymphocyte counts less than 350/μL group was (4 214±2 635)μg/L,which was higher than that of patients with CD4 + T lymphocyte counts more than 350/μL ([2 275 ±1 457 ]μg/L).The difference was statistically significant(t=-5 .41 ,P <0.01).The plasma sCD14 level in patients infected with HIV 181 -360 d was significantly higher than that in patients infected with HIV 1 - 30 days ([4 485 ± 2 779]μg/L vs [2 577 ±1 635 ]μg/L;t = -3.39,P <0.05 ).The plasma sCD14 level was positively correlated with HIV viral load (r =0.35,P =0.000 1 ),and negatively correlated with CD4 + T lymphocyte counts (r=-0.28,P =0.001 ).Conclusions The plasma sCD14 level in patients with acute phase of HIV infection is higher than that of healthy people,which increases with prolonged HIV infection.Plasma sCD14 level in of HIV infection acute phase may be closely related to HIV/AIDS progression.