血必净对急性弥漫性腹膜炎患者Toll样受体及炎性介质表达的影响  

Effect of Xue Bi Jing on toll-like receptor and inflammatory medium in acute diffuse peritonitis patients combined with systemic inflammatory response syndrome

作　　者：李大伟[1] 王非[1] 祝智军[1] 

机构地区：[1]浙江省中医院普外科,杭州市310018

出　　处：《中华全科医学》2014年第6期859-861,916,共4页Chinese Journal of General Practice

基　　金：2012浙江省医药卫生科技计划一般项目(2012kyb143)

摘　　要：目的观察血必净干预下急性弥漫性腹膜炎合并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TLR2 mRNA和TLR4 mRNA及下游炎症介质TNF-α和IL-6的表达,探讨血必净对SIRS的疗效机制。方法将62例符合纳入标准的患者分为SIRS组(33例)与非SIRS组(29例),另外设立健康平行对照组30例。RT-PCR法检测治疗前后PBMC中TLR2 mRNA和TLR4 mRNA表达变化,及ELISA检测治疗前及治疗的第1、3、5、7天血清炎症介质TNF-α和IL-6的变化,经t检验比较各组间的差异性。结果 33例SIRS患者经血必净干预后PBMC中TLR2 mRNA(0.51±0.14)和TLR4 mRNA(0.62±0.23)及血清TNF-α(36.89±12.23)、IL-6(40.27±30.31)表达均显著下降,且SIRS组降低较非SIRS组差异有统计学意义(P<0.05)。结论急性弥漫性腹膜炎SIRS组TLR2 mRNA和TLR4 mRNA及血清TNF-α、IL-6表达均显著下降且症状减轻,提示血必净在阻断炎症发生发展过程中可能发挥一定的作用。Objective To observe the effect of Xue Bi Jing on toll-like receptor TLR2 mRNA and TLR4 mRNA of periph- eral blood mononuclear cell（PBMC） and inflammatory medium TNF-α and IL-6 in acute diffuse peritonitis patients com- bined with systemic inflammatory response syndrome（SIRS） and to discuss the therapeutic mechanism of Xue Bi Jing on patients combined with SIRS. Methods A study was performed on 62 acute diffuse peritonitis patients in which 33 com- bined with SIRS. Another 30 healthy individuals were served as normal control. The mRNA expression of TLR2 mRNA and TLR4 mRNA was detected by RT-PCR;and that of TNF-α and IL-6 was measured on pre-treatment and the 1,3,5,7 day by ELISA. Results After treatment with Xue Bi Jing, TLR2 mRNA （ 0.51 ± 0. 14 ） and TLR 4 mRNA （ 0.62 ± 0.23 ）, TNF-et（36.89 ± 12.23） ,IL-6（40.27 ± 30.31 ） were downregulated markedly in 33 patients combined with SIRS. The down indexes in SIRS group were lower than those in non-SIRS group （ P 0.05 ）. Conclusion Patients combined with SIRS,the expression of TLR2 mRNA and TLR4 mRNA, TNF-α, IL-6 decreased markedly, which indicated Xue Bi Jing might play an important role in preventing inflammatory.

关 键 词：血必净 急性弥漫性腹膜炎 全身炎症反应综合征 TOLL样受体 炎性介质 

分 类 号：R656.41[医药卫生—外科学]