结核性胸膜炎患者胸腔积液中TLR2、TLR4水平变化及临床意义  

Changes and clinical significance of TLR2 and TLR4 levels in pleural effusion of patients with tuberculous pleurisy

作　　者：叶涛生[1] 张娇红[1] 张培泽[1] 曾旋 徐宇翔 李敏[1] YE Taosheng;ZHANG Jiaohong;ZHANG Peize;ZENG Xuan;XU Yuxiang;LI Min(Respiratory Endoscopy Room, the Third People′s Hospital of Shenzhen, Guangdong Province, Shenzhen 518000, China)

机构地区：[1]深圳市第三人民医院呼吸内镜诊疗室

出　　处：《中国医药导报》2019年第17期117-120,共4页China Medical Herald

基　　金：广东省医学科学技术研究基金项目(B2018045)

摘　　要：目的探讨结核性胸膜炎患者胸腔积液中Toll样受体2(TLR2)、Toll样受体4(TLR4)水平变化及临床意义。方法选取2016年1月~2018年12月深圳市第三人民医院(以下简称“我院”)收治的102例结核性胸膜炎患者(A组),另选取80例恶性胸腔积液患者(B组)、62例细菌性肺炎患者(C组),采用酶联免疫吸附试验检测TLR2、TLR4、肿瘤坏死因子-α(TNF-α)、单核细胞趋化蛋白-2(MCP-2)、基质金属蛋白酶-1(MMP-1)水平,采用Pearson相关性分析TLR2、TLR4与TNF-α、MCP-2、MMP-1的相关性,采用受试者工作特征曲线(ROC)分析TLR2、TLR4的诊断价值。结果 A组TLR2、TNF-α、MCP-2、MMP-1水平均高于B组、C组(P < 0.05)。Pearson相关系数分析可知,结核性胸膜炎患者TLR2与TNF-α、MCP-2、MMP-1均呈正相关(P < 0.05),而TLR4与TNF-α、MCP-2、MMP-1均无相关性(P > 0.05)。结核性胸膜炎患者TLR2与TLR4呈显著正相关(P < 0.05)。TLR2诊断结核性胸膜炎的曲线下面积为0.724,显著高于TLR4的曲线下面积0.518(P < 0.05)。结论结核性胸膜炎患者TLR2水平呈现明显升高趋势,且与胸腔积液中TNF-α、MCP-2、MMP-1均呈显著正相关,提示其可能参与着结核性胸膜炎病情的发生发展,对结核性胸膜炎有较好的诊断价值。Objective To investigate the changes and clinical significance of Toll-like receptor 2 (TLR2) and Toll-like receptor 4 (TLR4) levels in pleural effusion of patients with tuberculous pleurisy. Methods From January 2016 to December 2018, 102 patients with tuberculous pleurisy who were admitted to the Third People′s Hospital of Shenzhen ("our hospital" for short) were selected(group A), and 80 patients with malignant pleural effusion (group B) and 62 patients with bacterial pneumonia(group C). The enzyme-linked immunosorbent assay was used to detect all the TLR2 and TLR4, tumor necrosis factor alpha (TNF-α), monocyte chemotactic protein-2 (MCP-2), matrix metalloproteinase 1 (MMP-1) levels, Pearson correlation coefficient method was used to analyze correlation of TLR2, TLR4 and TNF-α, MCP-2, MMP 1;the receiver-operating characteristic curve (ROC) analysis was adopted to assess the diagnostic value of TLR2 and TLR4. Results The levels of TLR2, TNF-α, MCP-2 and MMP-1 in group A were higher than those in group B and group C (P < 0.05). Pearson correlation coefficient analysis showed that TLR2 was positively correlated with TNF-α, MCP-2 and MMP-1 in tuberculous pleurisy (P < 0.05), while TLR4 was not correlated with TNF-α, MCP-2 and MMP-1 (P > 0.05). TLR2 was positively correlated with TLR4 in patients with tuberculous pleurisy (P < 0.05). The area under the curve of TLR2 in diagnosis of tuberculous pleurisy was 0.724, which was significantly higher than that under the curve of TLR4 (P < 0.05). Conclusion TLR2 levels in tuberculous pleurisy patients show a significant upward trend, and are significantly positively correlated with TNF-α, MCP-2 and MMP-1 in pleural effusion, which may be involved in the occurrence and development of tuberculous pleurisy and have a better diagnostic value for tuberculous pleurisy.

关 键 词：结核性胸膜炎 胸腔积液 TLR2 TLR4 临床意义 

分 类 号：R52[医药卫生—内科学]