血液透析巨细胞病毒感染炎症反应状态和TLRs/MYD88信号通路水平  

Inflammatory response state and TLRs/MYD88 signaling pathway of hemodialysis patients with cytomegalovirus infection

作　　者：费毕艳 苟晶绮[1] 王宁宁[1] 李月美[2] 刘守红[3] FEI Bi-yan;GOU Jing-qi;WANG Ning-ning;LI Yue-mei;LIU Shou-hong(Qinghai Provincial People's Hospital,Xining,Qinghai 810000,China)

机构地区：[1]青海省人民医院血液净化中心,青海西宁810000 [2]青海省人民医院护理部,青海西宁810000 [3]青海省人民医院护理教研室,青海西宁810000

出　　处：《中华医院感染学杂志》2021年第14期2164-2168,共5页Chinese Journal of Nosocomiology

基　　金：青海省科研基金资助项目(201821414)。

摘　　要：目的探究血液透析(HD)巨细胞病毒(CMV)感染炎症反应状态和Toll样受体/髓样分化因子88(TLRs/MYD88)信号通路水平。方法选择2017年12月-2019年12月青海省人民医院住院治疗的HD患者150例,根据患者是否合并CMV感染将其分为HD合并CMV组(n=37)和HD组(n=113),比较两组患者T淋巴细胞亚群(CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+))水平、炎性因子[白细胞介素(IL)-2、IL-6、IL-10、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)、中性粒细胞明胶酶相关脂质运载蛋白(NAGL)]水平以及TLRs/MYD88信号通路(TLR2、TLR4、MYD88 mRNA)表达水平。结果HD合并CMV组患者CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)水平低于HD组、CD_(8)^(+)水平高于HD组(均P<0.05),CD_(3)^(+)水平与HD组比较,无统计学差异;HD合并CMV组患者IL-2、IL-6、TNF-α、IFN-γ、NAGL水平高于HD组、IL-10水平低于HD组(均P<0.05);HD合并CMV组患者TLR2、TLR4、MYD88 mRNA表达水平高于HD组(P<0.05)。结论CMV感染可导致HD患者T淋巴细胞异常,加重患者炎性反应,其机制可能为上调TLR2、TLR4、MYD88表达,从而激活TLRs/MYD88信号通路。OBJECTIVE To explore the inflammatory response state and Toll-like receptor/myeloid differentiation factor 88(TLRs/MYD88)signaling pathway of the hemodialysis(HD)patients with cytomegalovirus(CMV)infection.METHODS A total of 150 HD patients who were hospitalized in Qinghai Provincial People’s Hospital from Dec 2017 to Dec 2019 were enrolled in the study and divided into the HD complicated with CMV group with 37 cases and the HD group with 113 cases according to the status of complication with CMV infection.The levels of T lymphocyte subsets(CD_(3)^(+),CD_(4)^(+),CD_(8)^(+)CD_(4)^(+)/CD_(8)^(+)),inflammatory factors[interleukin(IL)-2),IL-6,IL-10,tumor necrosis factor-α(TNF-α),interferon-γ(INF-γ),neutrophil gelatinase-associated lipocalin(NAGL)]and TLRs/MYD88 signaling pathways(TLR2,TLR4,MYD88 mRNA)were observed and compared between the two groups of patients.RESULTS The levels of CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+)of the HD complicated with CMV group were significantly lower than those of the HD group,and the CD_(8)^(+)level of the HD complicated with CMV group was significantly higher than that of the HD group(all P<0.05),there was no significant difference in the CD_(3)^(+)level between the HD complicated with CMV group and the HD group.The levels of IL-2,IL-6,TNF-α,IFN-γand NAGL of the HD complicated with CMV group were significantly higher than those of the HD group,while the IL-10 level of the HD complicated with CMV group was significantly lower than that of the HD group(all P<0.05).The expression levels of TLR2,TLR4 and MYD88 mRNA of the HD complicated with CMV group were significantly higher than those of the HD group(P<0.05).CONCLUSION The CMV infection may result in the abnormal expression of T lymphocytes in the HD patients and aggravate the inflammatory response,of which the mechanisms may upregulate the expression of TLR2,TLR4 and MYD88 so as to activate the TLRs/MYD88 signaling pathway.

关 键 词：巨细胞病毒 血液透析 Toll样受体 髓样分化因子88 炎性因子 

分 类 号：R459.5[医药卫生—治疗学]