TLR2和TLR4在结核性胸膜炎患者胸腔积液中的检测  

Levels and significances of TLR2 and TLR4 in pleural effusion of patients with tuberculous pleurisy

作　　者：戚明 门浩 李成伟 王福琴 刘永娟 QI Ming;MEN Hao;LI Cheng-wei;WANG Fu-qin;LIU Yong-juan(Department of Internal Medicine,West District Hospital of Dezhou Traditional Chinese Medicine Hospital,Dezhou,Shandong 253000,China)

机构地区：[1]德州市中医院西院区内科,山东德州253000 [2]德州市立医院急诊科,山东德州253000

出　　处：《中国临床研究》2018年第11期1508-1511,共4页Chinese Journal of Clinical Research

基　　金：山东省中医药科技发展计划项目(2017-482)

摘　　要：目的研究在结核性胸膜炎患者胸腔积液Toll样受体(TLR)2和TLR4水平检测的应用及其意义。方法选择2016年3月至2017年10月收治的43例结核性胸膜炎患者(A组),41例恶性胸腔积液患者(B组)及45例细菌性肺炎患者(C组)。采用酶联免疫吸附法检测患者胸腔积液上清中TLR2和TLR4水平及肿瘤坏死因子(TNF)-α、基质金属蛋白酶(MMP)-1及单核细胞趋化因子(MCP)-2水平,分析结核性胸膜炎胸腔积液上清TLR2、TLR4与TNF-α、MMP-1、MCP-2的相关性及TLR2与TLR4的相关性。探讨TLR2和TLR4水平对结核性胸膜炎的诊断价值。结果 A组胸腔积液上清TLR2水平显著高于B组和C组(P <0. 05),三组胸腔积液上清TLR4水平差异无统计学意义(P> 0. 05);A组胸腔积液上清中TNF-α、MMP-1、MCP-2水平均显著高于B组和C组(P <0. 05)。A组胸腔积液上清TLR2分别与TNF-α、MMP-1、MCP-2呈显著正相关关系(r=0. 845、0. 753、0. 712,P=0. 000、0. 000、0. 000);A组胸腔积液上清中TLR2和TLR4呈显著正相关关系(r=0. 759,P=0. 000);TLR2诊断结核性胸膜炎的ROC曲线下面积(AUC)为0. 774,明显高于TLR4的AUC的0. 537(P <0. 05)。结论 TLR2在结核性胸膜炎患者胸腔积液中水平明显升高,与胸腔积液中TLR4、TNF-α、MMP-1、MCP-2水平相关,可能参与病情的发生发展,对结核性胸膜炎具有较好的诊断价值。Objective To study the application and significance of level detection of Toll-like receptor（TLR）2 and TLR4 in the pleural effusion of patients with tuberculous pleurisy. Methods From March 2016 to October 2017,43 patients with tuberculous pleurisy（group A）,41 patients with malignant pleural effusion（group B） and 45 patients with bacterial pneumonia（group C） were selected. The levels of TLR2 and TLR4 in hydrothorax supernatant were detected respectively,and the levels of tumor necrosis factor（TNF）-alpha,matrix metalloproteinase（MMP）-1 and monocyte chemoattractant factor（MCP）-2 were detected in hydrothorax supernatant. The associations of TLR2 and TLR4 with TNF-α,MMP-1 and MCP-2 and the correlation between TLR2 and TLR4 in buberculous pleurisy patients were analyzed and the diagnostic values of TLR2 and TLR4 levels in tuberculous pleurisy were explored. Results The level of TLR2 in group A was significantly higher than those in group B and group C（P〈0. 05）,but there was no significant difference in TLR4 level among three groups（P〉0. 05）. The levels of TNF-α,MMP-1 and MCP-2 in hydrothorax supernatant in group A were significantly higher than those in group B and group C（all P〈0. 05）. In group A,TLR2 in hydrothorax supernatant was positively correlated with TNF-a,MMP-1 and MCP-2 respectively（r = 0. 845,0. 753,0. 712,P = 0. 000,0. 000,0. 000）,and there was a significant positive correlation between TLR2 and TLR4（r = 0. 759,P = 0. 000）. The areas under the receiver operator characteristic（ROC） curve（AUC） of TLR2 was significantly higher than that of TLR4 in the diagnosis of tuberculous pleurisy（0. 774 vs 0. 537,P〈0. 05）. Conclusions The level of TLR2 significantly increases and is related to the levels of TLR4,TNF-a,MMP-1 and MCP-2 in pleural effusion of patients with tuberculous pleurisy. It may be involved in the development of the disease and has a higher diagnostic significance for tuberculous pleurisy.

关 键 词：TOLL样受体2 TOLL样受体4 结核性胸膜炎 胸腔积液 肿瘤坏死因子-α 基质金属蛋白酶-1 单核细胞趋化因子-2 

分 类 号：R521.7[医药卫生—内科学]