TLRs及其下游炎性因子在溃疡性结肠炎早期诊断及预后评估中的价值分析  

Analysis of the value of TLRs and its downstream inflammatory factors in the early diagnosis and prognostic evaluation of ulcerative colitis

作　　者：刁凌云[1] 皇金萍[1] 陈洋[1] 孙唱 王胜英 罗玉国 葛飞 DIAO Ling-yun;HUANG Jin-ping;CHEN Yang;SUN Chang;WANG Sheng-ying;LUO Yu-guo;GE Fei(Department of Gastroenterology Medicine,1.Xuzhou Affiliated Hospital of Nanjing University of Traditional Chinese Medicine,Xuzhou 221000;Hai an Hospital of Traditional Chinese Medicine Affiliated to Medical College of Yangzhou University,Hai an 226600,Jiangsu,China)

机构地区：[1]南京中医药大学徐州附属医院消化内科,江苏徐州221000 [2]扬州大学医学院附属海安市中医院消化科,江苏海安226600

出　　处：《川北医学院学报》2021年第12期1546-1551,共6页Journal of North Sichuan Medical College

基　　金：江苏省自然科学基金面上项目(BK20181235)。

摘　　要：目的:探讨Toll样受体家族(TLRs)及其下游炎症因子[核转录因子κB(NF-κB)、肿瘤坏死因子(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-10(IL-10)、髓过氧化物酶(MPO)]在溃疡性结肠炎(UC)早期诊断及预后评估中的价值。方法:选取108例UC患者为研究对象(研究组),依据UC所处时期分为活动期组(n=70)和缓解期组(n=38);活动期组再依据病情分为轻度组(n=21)、中度组(n=27)及重度组(n=22),依据预后分为预后良好组(n=44)及预后不良组(n=26);另选同期102例结肠镜检查未见异常者为对照组。比较各组患者TLR2、TLR4、NF-κB蛋白表达水平及IL-1β、TNF-α、IL-10水平、MPO活性、严重程度指数(UCEIS)评分及疾病活动指数(DAI)分级,分析各指标在溃疡性结肠炎早期诊断及预后评估中的价值。结果:活动期组、缓解组及对照组TLR2、TLR4、NF-κB、IL-1β、TNF-α水平及MPO活性比较,差异有统计学意义(P<0.05),且活动期组>缓解期组>对照组;IL-10水平比较,差异有统计学意义(P<0.05),且活动期组<缓解期组<对照组。轻度组、中度组及重度组TLR2、TLR4、NF-κB、IL-1β、TNF-α水平及MPO活性比较,差异有统计学意义(P<0.05),且重度组>中度组>轻度组;IL-10水平比较,差异有统计学意义(P<0.05),且重度组<中度组<轻度组低。预后不良组病理组织分级、UCEIS评分、DAI评分分级、TLR2、TLR4、NF-κB、IL-1β、TNF-α、IL-10、MPO活性与预后良好组比较,差异有统计学意义(P<0.05)。UCEIS评分>6分、TLR2、TLR4、NF-κB、IL-1β、TNF-α、MPO活性升高及IL-10水平降低是影响UC患者预后不良的独立危险因素(P<0.05)。ROC分析显示,TLR2、TLR4、NF-κB、IL-1β、TNF-α、IL-10、MPO活性、UCEIS评分及DAI评分分级联合预测的AUC高于单一检测指标。结论:TLRs、炎性因子、MPO活性与患者UC的严重程度相关,联合检测TLRs及炎性因子可作为早期诊断UC及预测预后的有效指标之一。Objective:To analyze Toll-like receptor family(TLRs),nuclear transcription factor kappa B(NF-κB),tumor necrosis factor(TNF-α),interleukin-1β(IL-1β),interleukin-10(IL-10),and myeloperoxidase(MPO)activity in the early diagnosis and prognostic evaluation of ulcerative colitis(UC).Methods:108 UC patients were selected as the research object(research group).According to the period of UC,they were divided into active phase group(n=70)and remission phase group(n=38),the active group was divided into mild group(n=21),moderate group(n=27)and severe group(n=22)according to the condition,and divided into good prognosis group(n=44)and poor prognosis group(n=26)according to the prognosis.At the same time,another 102 patients with no obvious abnormality in colonoscopy were selected as the control group.The protein expression level of TLR2,TLR4,and NF-κB,IL-1β,TNF-α,IL-10,MPO activity,severity index(UCEIS)score and disease activity index(DAI)score were compared between the groups.The value of each index in the early diagnosis and prognosis of ulcerative colitis was analyzed.Results:There was significant difference in TLR2,TLR4,NF-κB,IL-1β,TNF-αand MPO activity among active group,remission group and control group(P<0.05),and active group>remission group>control group.There was significant difference in the levels of IL-10(P<0.05),and active group<remission group<control group.There was significant difference in TLR2,TLR4,NF-κB,IL-1β,TNF-αand MPO activity among mild group,moderate group and severe group(P<0.05),and severe group>moderate group>mild group.There was significant difference in the levels of IL-10(P<0.05),and severe group<moderate group<mild group.The pathological tissue classification,UCEIS score,DAI score classification,TLR2,TLR4,NF-κB,IL-1β,TNF-α,IL-10 and MPO activity in the poor prognosis group were statistically significant compared with those in the good prognosis group(P<0.05).UCEIS score>6 points,TLR2,TLR4,NF-κB,IL-1β,TNF-α,MPO activity increased and IL-10 levels decreased were independent r

关 键 词：溃疡性结肠炎 TOLL样受体 NF-ΚB 炎性因子 MPO 早期诊断 预后 

分 类 号：R574.62[医药卫生—消化系统]