急性弥漫性腹膜炎SIRS患者Toll样受体及炎症介质的表达变化  

Expression and significance of toll-like receptor 2,4 and inflammatory medium in acute diffuse peritonitis patients combined with systemic inflammatory response syndrome

作　　者：汪洋[1] 熊京[1] 吴河水[1] 田元[1] 张锦辉[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院急诊外科,湖北武汉430022

出　　处：《中国急救医学》2005年第6期399-401,共3页Chinese Journal of Critical Care Medicine

基　　金：国家自然科学基金资助项目(No.30200274)

摘　　要：目的观察急性弥漫性腹膜炎并发全身炎症反应综合征(SIRS)患者外周血单个核细胞(PBMC)Toll样受体(TLR)2,4mRNA及下游炎症介质的表达变化,探讨TLR与SIRS的关系。方法72例急性弥漫性腹膜炎患者分为SIRS组(45例)与非SIRS组(27例),另设40例健康志愿者为对照组。采用鲎试剂法检测血浆LPS水平,RT-PCR法检测PBMC中TLR2,4mRNA的表达,ELISA法检测血清TNF-α和IL-6的表达。结果72例急性弥漫性腹膜炎患者血浆LPS浓度、PBMC中TLR2,4mRNA及血清TNF-α和IL-6表达均显著增高,且SIRS组增高较非SIRS组有显著统计学意义(P<0.01)。结论急性弥漫性腹膜炎SIRS患者PBMC中TLR2,4基因表达显著增加,提示TLR在急性弥漫性腹膜炎SIRS的发生发展过程中发挥了重要的作用。Objective To explore the changes of toll-like receptor(TLR)2,4 of peripheral blood mononuclear cell(PBMC) in acute diffuse peritonitis patients combined with systemic inflammatory response syndrome(SIRS) and their potential significance.Methods A clinical study was performed on 72 acute diffuse peritonitis patients in which 45 combined with SIRS.Another 40 healthy individuals served as normal control.The mRNA expression of TLR2,4 was detected by RT-PCR;the expression of TNF-α and IL-6 was measured by ELISA;the level of plasma endotoxin,the length of stay and the mortality were observed.Results TLR2,4mRNA,endotoxin,IL-6 and TNF-α were upregulated markedly in acute diffuse peritonitis patients.The above indexes in SIRS group were higher than those in non-SIRS group(P<0.01).Conclusion In acute diffuse peritonitis patients combined with SIRS,the expression of TLR2,4 of PBMC increased markedly,which indicated that TLR might play an important role in the pathogenesis of SIRS.

关 键 词：TOLL样受体 急性弥漫性腹膜炎 全身炎症反应综合征 

分 类 号：R656.41[医药卫生—外科学]