严重脓毒症患者外周血单个核细胞Toll样受体2、4和髓样分化因子88在胸腺肽α1治疗过程中的基因表达变化  

Changes of TLR2, TLR4 and MyD88 mRNA expressions on peripheral blood mononuclear cell in severe sepsis patients during treatment with Thymosin α1

作　　者：吴健锋[1] 唐朝霞[1] 陈娟[1] 欧阳彬[1] 陈敏英[1] 管向东[1] 

机构地区：[1]中山大学附属第一医院SICU,广州510080

出　　处：《中华普通外科学文献（电子版）》2014年第4期10-14,共5页Chinese Archives of General Surgery(Electronic Edition)

基　　金：中山大学5010临床研究基金(2007015);广东省自然科学基金(8151008901000079;10451008901006286);广东省医学科研基金(B2010074)

摘　　要：目的观察严重脓毒症患者外周血单个核细胞Toll样受体(TLR)2、4基因及其信号传导通路上的髓样分化因子88(MyD88)基因表达水平在胸腺肽α1治疗过程中的变化。方法 54例严重脓毒症患者被随机分为对照组(常规治疗,28例)和治疗组(胸腺肽α1治疗,26例),采用实时荧光定量PCR监测两组患者入院时及治疗后第3、7天外周血单个核细胞TLR2、TLR4和MyD88基因表达水平变化,并观察两组的28 d病死率。结果治疗组的28 d病死率虽低于对照组,但差异无统计学意义(23.1%vs 35.7%,P=0.310)。治疗组的患者单核细胞TLR2、TLR4和MyD88基因表达水平逐渐上升,而对照组未见该规律,与对照组相比,治疗后第3天时治疗组的TLR2(2.31±0.79 vs 1.83±0.51)、TLR4基因表达增高(7.31±0.79 vs 6.55±0.92);第7天时治疗组TLR2(2.75±1.17 vs 1.63±0.36)、TLR4(7.75±1.03 vs 6.39±0.72)和MyD88(4.26±0.77 vs 3.77±0.68)水平明显增高,均P<0.05。结论胸腺肽α1在治疗严重脓毒症患者过程中可以上调患者单核细胞的TLR2、4和MyD88基因的表达水平。Objective To examine the TLR2, TLR4 and MyD88 mRNA expressions on human peripheral blood mononuclear cells during treatment. Methods A prospective randomized controlled trial was designed. Fifty-four patients with severe sepsis were enrolled and randomized into thymosin group （26 cases, treated with thymosin alpha 1） and control group （28 cases）. TLR2, TLR4 and MyD88 mRNA were tested by RT-PCR on the day of enrollment, day 3 and day 7 after treatment in both groups, 28-day mortality in these patients was analyzed. Results There was no statistically significant difference between 28-day mortality rate in the control group and that of thymosin group （35.7% vs 23.1%, P=0.310）. TLR2, TLR4 and MyD88 mRNA expressions in the thymosin group were respectively increased on enrollment day, day 3 and day 7, while this increasing trend was not found in the control group. On day 3, TLR2 and TLR4 mRNA expressions in the thymosin group were higher than those in the control group （2.31 ± 0.79 vs 1.83 ± 0.51, 7.31 ± 0.79 vs 6.55 ± 0.92, P 〈 0.05）. On day 7, TLR2, TLR4 and MyD88 mRNA expressions in the thymosin group werehigher than those in the control group （2.75 ± 1.17 vs 1.63 ± 0.36, 7.75 ± 1.03 vs 6.39 ± 0.72, 4.26 ± 0.77 vs 3.77 ± 0.68, P 〈 0.05）. Conclusion Thymosin alpha 1 may increase TLR2, TLR4 and MyD88 mRNA expressions in severe sepsis patients.

关 键 词：脓毒症 胸腺肽仅α1 TOLL样受体 髓样分化因子88 

分 类 号：R459.7[医药卫生—急诊医学]