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目的观察血浆可溶性白细胞分化抗原14(sCD14)在艾滋病病毒1型(HIV-1)感染者联合高效抗反转录病毒治疗(HAART)过程中表达水平的变化,探讨HAART过程中血浆sCD14的变化规律及意义。方法以26例HIV-1感染者为研究对象,20名健康献血者为对照。用酶联免疫吸附试验(ELISA)检测健康对照组和HIV-1感染者HAART前(基线)和治疗后12、24、36及48周的血浆sCD14水平,分析sCD14表达水平变化及其与病毒学、免疫学应答的关系。结果 26例HIV-1感染者与20例对照组年龄及性别比较差异无统计学意义(t=1.813,P=0.07;χ~2=0.001,P=0.971)。HIV-1感染组基线血浆sCD14水平为(4.72±2.84)×10~6pg/mL,明显高于对照组(0.59±0.32)×10~6pg/mL(t=6.468,P<0.001),且治疗后呈明显下降趋势(F=25.975,P<0.001)。HIV-1感染组血浆sCD14在治疗12周时达(5.92±5.27)×10~6 pg/mL,与基线比较差异无统计学意义(t=1.026,P=0.315);治疗24周后迅速下降至(0.44±0.35)×10~6pg/mL,明显低于基线(t=-7.630,P<0.001),并接近对照组水平(t=1.436,P=0.158);随后血浆sCD14维持低水平,36周及48周时分别为(0.52±0.25)×10~6 pg/mL和(0.60±0.36)×10~6pg/mL,与24周及对照组比较差异均无统计学意义(t=0.825,P=0.417;t=1.558,P=0.132;t=0.863,P=0.393;t=1.80,P=0.858)。治疗24周血浆sCD14变化与Th/Ts比值变化呈负相关(r=-0.477,P=0.013),48周时血浆sCD14变化与HIV-1RNA变化呈正相关(r=0.428,P=0.029)。结论血浆sCD14在HIV-1感染者中上升,经过有效HAART后下降,有望成为HAART疗效判断的指标。
Objective To observe the changes of plasma soluble CD40 (sCD14) expression in patients with HIV-1 infected with HAART and explore the change of plasma sCD14 in HAART And meaning. Methods Twenty-six HIV-1 infected subjects were enrolled in this study. Twenty healthy blood donors were used as controls. Serum levels of sCD14 were measured by enzyme-linked immunosorbent assay (ELISA) before HAART (baseline) and at 12, 24, 36 and 48 weeks after HAART in HIV-1 infected patients and HIV-1 infected patients, , The relationship between immunological response. Results There was no significant difference in age and sex among 26 HIV-1 infected patients and 20 controls (t = 1.813, P = 0.07; χ ~ 2 = 0.001, P = 0.971). The level of plasma sCD14 in HIV-1 infection group was (4.72 ± 2.84) × 10 ~ 6 pg / mL, significantly higher than that in the control group (0.59 ± 0.32 × 10 ~ 6 pg / mL, t = 6.468, After a significant downward trend (F = 25.975, P <0.001). The plasma sCD14 in HIV-1 infected group was (5.92 ± 5.27) × 10 ~ 6 pg / mL at 12 weeks of treatment, with no significant difference from baseline (t = 1.026, P = 0.315) 0.44 ± 0.35) × 10-6 pg / mL, which was significantly lower than the baseline (t = -7.630, P <0.001) and close to the control group (t = 1.436, P = 0.158) (0.52 ± 0.25) × 10 ~ 6 pg / mL and (0.60 ± 0.36) × 10 ~ 6 pg / mL at 48 weeks and no significant difference compared with those of 24 weeks and control group (t = 0.825, P = 0.417; t = 1.558, P = 0.132; t = 0.863, P = 0.393; t = 1.80, P = 0.858). At 24 weeks, there was a negative correlation between plasma sCD14 and Th / Ts ratio (r = -0.477, P = 0.013). There was a positive correlation between plasma sCD14 and HIV-1 RNA level at 48 weeks (r = 0.428, P = 0.029). Conclusions The plasma sCD14 level rises in HIV-1 infected patients and decreases after effective HAART. It is expected to become an index of curative effect of HAART.