重症脓毒症患者外周血单核细胞TLR4和炎性因子的表达及临床意义  

The expression and clinical significance of TLR4 and inflammatory factors in peripheral blood mononuclear cell in patients with severe sepsis

作　　者：郭皓[1] 张山[1] 

机构地区：[1]河北省邯郸市中心医院,056000

出　　处：《河北医药》2011年第22期3376-3378,共3页Hebei Medical Journal

基　　金：河北省邯郸市科学技术研究与发展计划项目(编号:1023108100-5)

摘　　要：目的观察重症脓毒症患者外周血单核细胞(PBMC)膜结合CD14(mCD14)、TLR4及炎性因子的表达及临床意义。方法选取符合重症脓毒症患者35例和健康志愿者15例作为对照。在患者被诊断重症脓毒症的第1、3、5天测定其外周血单核细胞mCD14、TLR4的表达及血清肿瘤坏死因子(TNF-α)、白细胞介素-10(IL-10)浓度、当天的APACHE-Ⅱ评分和SOFA评分及预后。结果按预后分为生存组(25例)和死亡组(10例),第1、3天2组PBMC表面mCD14、TLR4比较差异无统计学意义(P>0.05),生存组PBMC表面mCD14、TLR4第5天升高,并高于死亡组的对应值(P<0.05);APACHE-Ⅱ、SOFA评分明显下降,2组血清TNF-α、IL-10各点均没有发生明显变化,差异无统计学意义(P>0.05)。结论重症脓毒症患者外周血单核细胞mCD14、TLR4表达与患者预后密切相关,血清TNF-α、IL-10的动态变化不能反映患者疾病的演变和预后。Objective To investigate the expression and clinical significance of mCD14, TLR4 and inflammatory factors in peripheral blood mononuclear cell （ PBMC ） in patients with severe sepsis. Methods Thirty-five patients with severe sepsis and fifteen healthy volunteers （control group ） were enrolled in the investigation,and the patients were subdivided into two groups according to their prognoses, survival group （ n = 25 ） and death group （ n = 10）. The expression levels of mCD14 ,TLR4 in PBMC and TNF-α,IL-IO in serum were detected at 1,3,5days after they were diagnosed, the APACHE-Ⅱ scoring and SOFA scoring at the first day were performed, and the patients＇ prognoses were evaluated. Results There were no significant differences in the expression levels of mCD14,TLR4 in PBMC at 1,3 days between survival group and death group （ P 〉0. 05）, with mCD14 （2.62 ± 1.70 vs 2.58 ± 1.33 ）, （ 3.21 ± 1.78 vs 2.89± 1.73 ）, TLR4 （ 10.15±9.70 vs 11.09 ±8.92）, （ 14.86 ± 12.56 vs 11.09 ± 8.92） respectively, however, which were significantly increased at the 5th day in survival group,as compared with those in death group （5.12 ± 2.03 vs 2.75± 0. 67 ）, （28.86 ± 18.68 vs 13.41± 1.73）（ P 〈 0.05 ）. While APACHE-Ⅱ scoring and SOFA scoring were obviously decreased, but there were no significant differences in the levels of serum TNF-α and IL-10 at 1,3,5days between the two groups （ P 〉0. 05 ）. Conclusion The expression of mCD14 on PBMC in patients with severe sepsis is closely related with the patients＇ prognoses, but the dynamic change of serum levels of TNF-αand IL-IO can not reflect the variation of disease and patients＇ prognoses.

关 键 词：MCD14 TLR4 重症脓毒症 炎性因子类 

分 类 号：R631.2[医药卫生—外科学]