社区获得性肺炎并发呼吸衰竭患者外周血SOCS-1、TLR4表达及临床意义  

The expressions of SOCS-1 and TLR4 in peripheral blood of patients with community acquired pneumonia complicated by respiratory failure and their clinical significance

作　　者：李明旭 朱国清 唐建辉 郁帆 杨志军 LI Mingxu;ZHU Guoqing;TANG Jianhui(Department of Critical Medicine,Ma’anshan General Hospital of Ranger-Duree Healthcare,Liaoning,Ma’anshan 243000,China)

机构地区：[1]德驭医疗马鞍山总医院重症医学科,安徽省马鞍山市243000

出　　处：《河北医药》2022年第14期2106-2110,共5页Hebei Medical Journal

摘　　要：目的探讨细胞因子信号转导抑制因子-1(SOCS-1)、Toll样受体4(TLR4)在CAP并发呼吸衰竭患者外周血单个核细胞中的表达及临床意义。方法选取2019年1月至2021年3月诊治的89例CAP并发呼吸衰竭患者为观察组,同期选取86例CAP但未并发呼吸衰竭患者作为对照组;观察组随访1个月,根据患者的生存情况将其分为生存组70例和死亡组19例。实时荧光定量PCR(qRT-PCR)法检测外周血单个核细胞SOCS-1 mRNA、TLR4 mRNA水平;Pearson法分析观察组SOCS-1 mRNA、TLR4 mRNA水平与急性生理与慢性健康评分Ⅱ(APACHEⅡ)评分的相关性;受试者工作特征曲线(ROC曲线)分析外周血单个核细胞SOCS-1 mRNA、TLR4 mRNA评估CAP并发呼吸衰竭患者预后的价值;多因素Logistic回归分析影响CAP并发呼吸衰竭患者预后的因素。结果观察组外周血单个核细胞SOCS-1 mRNA、TLR4 mRNA水平和APACHEⅡ评分高于对照组(P<0.05)。观察组SOCS-1 mRNA、TLR4 mRNA水平与APACHEⅡ评分呈正相关(r=0.539、0.613,P<0.05)。死亡组外周血单个核细胞SOCS-1 mRNA、TLR4 mRNA水平及APACHEⅡ评分高于生存组(P<0.05)。SOCS-1 mRNA、TLR4 mRNA单独评估CAP并发呼吸衰竭患者预后的曲线下面积(AUC)均小于二者联合评估AUC(Z=1.660、1.830,P<0.05)。SOCS-1 mRNA、TLR4 mRNA水平及APACHEⅡ评分均是影响CAP并发呼吸衰竭患者死亡的重要因素(P<0.05)。结论外周血单个核细胞中SOCS-1、TLR4水平可作为CAP并发呼吸衰竭患者病情判断及预后评估的参考指标。Objective To investigate the expressions and clinical significance of suppressor of cytokine signaling-1(SOCS-1)and Toll-like receptor 4(TLR4)in peripheral blood mononuclear cells of patients with community acquired pneumonia(CAP)complicated by respiratory failure.Methods A total of 89 patients with CAP complicated by respiratory failure who were treated in our hospital from January 2019 to March 2021 were enrolled as observation group,at the same time,the other 86 patients with CAP without respiratory failure were enrolled as control.The patients in observation group were followed up for 1 month,then,who were divided into survival case group(n=70)and death case group(n=19).Real-time fluorescent quantitative PCR(qRT-PCR)was used to detect the levels of SOCS-1 mRNA and TLR4 mRNA in peripheral blood mononuclear cells;Pearson method was used to analyze the correlation between the levels of SOCS-1 mRNA,TLR4 mRNA and the Acute Physiology and Chronic Health ScoreⅡ(APACHEⅡ)score in observation group;receiver operating characteristic curve(ROC curve)was used to analyze the value of SOCS-1 mRNA and TLR4 mRNA in peripheral blood mononuclear cells in assessing the prognosis of patients with CAP complicated by respiratory failure;multivariate Logistic regression was used to analyze the factors affecting the prognosis of patients with CAP complicated by respiratory failure.Results The levels of SOCS-1 mRNA,TLR4 mRNA and APACHEⅡscores in observation group were significantly higher than those in control group(P<0.05).The levels SOCS-1 mRNA and TLR4 mRNA levels in observation group were positively correlated with APACHEⅡscores(P<0.05).Moreover the levels of SOCS-1 mRNA,TLR4 mRNA and APACHEⅡscores in death case group were significantly higher than those in survival case group(P<0.05).The area under the curve(AUC)of SOCS-1 mRNA and TLR4 mRNA alone in evaluating the prognosis of patients with CAP complicated by respiratory failure was less than that by combined evaluation(P<0.05).In addition the levels of SOCS-1 mRNA,TLR4

关 键 词：CAP 呼吸衰竭 外周血单个核细胞 细胞因子信号转导抑制因子-1 TOLL样受体4 预后 

分 类 号：R563.8[医药卫生—呼吸系统]