脓毒症患者血清TOLL样受体4、脂联素与炎症反应和病情严重程度的关系  

Relationship between Serum TOLL-like Receptor 4, Adiponectin and Inflammation and Severity of Illness in Sepsis Patients

作　　者：刘坤 蒋文[1] 周玉玲[1] 张颜彦 胡婧[1] LIU Kun;JIANG WenIA;ZHOU Yu-ling;ZHANG Yan-yan;HU Jing(Emergency ICU,Chongqing Traditional Chinese Medicine Hospital,Chongqing,400020,China;Department of Orthopedics,Chongqing Traditional Chinese Medicine Hospital,Chongqing,400020,China)

机构地区：[1]重庆市中医院急诊ICU,重庆400020 [2]重庆市中医院骨科,重庆400020

出　　处：《现代生物医学进展》2019年第4期747-750,共4页Progress in Modern Biomedicine

基　　金：重庆市卫计委医学科研计划项目(201413021)

摘　　要：目的:探讨脓毒症患者血清TOLL样受体4(TLR4)、脂联素(APN)与炎症反应和病情严重程度的关系。方法:选取2016年12月到2018年4月期间在重庆市中医院接受治疗的脓毒症患者60例作为研究组,另选取同期本院健康体检者60例作为对照组。根据急性生理及慢性健康状况Ⅱ(APACHEⅡ)评分将脓毒症患者分为高分组17例(APACHEⅡ评分≥20分)和低分组43例(APACHEⅡ评分<20分)。比较两组血清中的TLR4、APN、降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)水平,比较高分组和低分组患者血清中的TLR4、APN及炎症因子水平,分析脓毒症患者TLR4、APN的表达与炎症因子、APACHEⅡ评分的相关性。结果:研究组血清中的TLR4、PCT、TNF-α、CRP水平均明显高于对照组,APN水平明显低于对照组(P<0.05)。高分组患者血清中的TLR4、PCT、TNF-α、CRP水平明显高于低分组,APN水平明显低于低分组(P<0.05)。脓毒症患者TLR4的表达与PCT、TNF-α、CRP、APACHEⅡ评分呈正相关,APN的表达与PCT、TNF-α、CRP、APACHEⅡ评分呈负相关(P<0.05)。结论:脓毒症患者病情越严重,TLR4水平越高,而APN水平越低,TLR4、APN可能是通过调节炎症反应来影响脓毒症患者的疾病进展。Objective: To investigate the relationship between the serum toll-like receptor 4(TLR4), adiponectin(APN) and inflammation and severity of illness in sepsis patients. Methods: 60 patients with sepsis who were treated in Chongqing Traditional Chinese Medicine Hospital from December 2016 to April 2018 were selected as the study group, and 60 healthy persons were selected as the control group during the same period. According to the Acute Physiology and Chronic Health Status Scale II(APACHE II), sepsis patients were divided into high score group with 17 cases(APACHE II score ≥20) and low score group with 43 cases(APACHE II score <20).The levels of serum TLR4, APN, procalcitonin(PCT), tumor necrosis factor-α(TNF-α) and C-reactive protein(CRP) in the two groups were compared. The levels of serum TLR4, APN and inflammatory factors in patients with high and low groups were compared. The correlation between TLR4, APN expression and inflammatory factors, APACHE II scores in sepsis patients was analyzed. Results: The levels of serum TLR4, PCT, TNF-α and CRP in the study group were significantly higher than those in the control group, and the APN level was significantly lower than that in the control group(P<0.05). The serum levels of TLR4, PCT, TNF-α, and CRP were significantly higher in high score group than those in low score group, and APN levels were significantly lower than that in low-score groups(P<0.05).The expression of TLR4 in patients with sepsis was positively correlated with PCT, TNF-α, CRP and APACHE II scores, the expression of APN was negatively correlated with PCT, TNF-α,CRP and APACHE II scores(P<0.05). Conclusion: TLR4 is highly expressed in serum of patients with sepsis, and APN is lowly expressed, TLR4 and APN may affect the disease progression in patients with sepsis by modulating the inflammatory response.

关 键 词：脓毒症:TOLL样受体4 脂联素 炎症反应 病情严重程度 

分 类 号：R631.2[医药卫生—外科学]