膀胱癌尿路感染患者免疫和炎症因子的表达及临床诊断价值  

Expression of immune and inflammatory factors in bladder cancer patients with urinary tract infection and clinical diagnostic values

作　　者：陈怡[1] 陈沛林[1] 吕晓磊 杨芳 刘红梅[3] CHEN Yi;CHEN Pei-lin;LYU Xiao-lei;YANG Fang;LIU Hong-mei(Tangshan Workers'Hospital,Tangshan,Hebei 063000,China;不详)

机构地区：[1]唐山市工人医院泌尿外科,河北唐山063000 [2]华北理工大学,河北唐山063000 [3]唐山市中心血站,河北唐山063000

出　　处：《中华医院感染学杂志》2022年第1期80-84,共5页Chinese Journal of Nosocomiology

基　　金：河北省自然科学基金资助项目(20195986)。

摘　　要：目的探讨尿路感染对膀胱癌患者Toll样受体(TLRs)信号通路和炎症、免疫功能的影响。方法选择2017年4月-2020年4月唐山市工人医院收治的105例膀胱癌术后尿路感染患者为研究组,另择同期收治的55例未发生尿路感染膀胱癌患者及50名健康体检者纳入非感染组及对照组,分析各组TLR4、TLR9基因相对表达量;测定CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)T淋巴细胞及免疫球蛋白M(IgM)、IgG、IgA表达水平;测定C-反应蛋白(CRP)、降钙素原(PCT)、白细胞介素(IL)-1、IL-6炎症因子水平。结果105例感染患者共分离病原菌112株,其中革兰阴性菌71株(63.39%)。感染组及非感染组TLR4、TLR9表达量高于对照组,感染组高于非感染组(P<0.05)。感染组患者CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)、IgM、IgG、IgA免疫功能指标低于非感染组及对照组,非感染组IgM、IgA水平低于对照组(P<0.05)。感染组患者CRP、PCT、IL-1、IL-6炎症因子水平高于非感染组及对照组,非感染组高于对照组(P<0.05)。TLR4、TLR9、CD_(4)^(+)/CD_(8)^(+)、IgM、IgG、IgA、CRP、PCT、IL-1、IL-6指标诊断膀胱癌术后尿路感染的曲线下面积均>60.0%。结论膀胱癌术后尿路感染患者存在TLRs信号通路活性的增强,免疫、炎症因子表达失调,这些指标水平的变化可作为诊断尿路感染及评估病情的参考指标。OBJECTIVE To explore the influence of urinary tract infection on Toll-like receptors(TLRs)signaling pathway,inflammation and immune function of the patients with bladder cancer.METHODS Totally 105 bladder cancer patients who had postoperative urinary tract infection in Tangshan Workers′Hospital from Apr 2017 to Apr 2020 were assigned as the study group,meanwhile,55 bladder cancer patients without urinary tract infection and 50 healthy people who received physical examination were respectively chosen as the non-infection group and the control group.The relative expression levels of TLR4 and TLR9 genes were observed,the levels of CD_(3)^(+),CD_(4)^(+) and CD_(8)^(+)T lymphocytes as well as immunoglobulin M(IgM),IgG and IgA immune indexes were determined,and the levels of inflammatory factors C-reactive protein(CRP),procalcitonin(PCT),interleukin-1(IL-1)and IL-6 were detected.RESULTS Totally 112 strains of pathogens were isolated from the 105 patients with infection,71(63.39%)of which were gram-negative bacteria.The expression levels of TLR4 and TLR9 of the infection group and the non-infection group were significantly higher than those of the control group,the levels of above indexes of the infection group were significantly higher than those of the non-infection group(P<0.05).The levels of immune function indexes CD_(3)^(+),CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+),IgM,IgG and IgA of the infection group were significantly lower than those of the non-infection group and the control group,and the levels of above indexes of the non-infection group were significantly lower than those of the control group(P<0.05).The levels of inflammatory factors CRP,PCT,IL-1 and IL-6 of the infection group were significantly higher than those of the non-infection group and the control group,and the levels of above indexes of the non-infection group were significantly higher than those of the control group(P<0.05).The areas under curves of the TLR4,TLR9,CD_(4)^(+)/CD_(8)^(+),IgM,IgG,IgA,CRP,PCT,IL-1 and IL-6 were more than 60.0%in diagnosis

关 键 词：膀胱癌 尿路感染 TOLL样受体 T淋巴细胞亚群比例 免疫球蛋白 炎症因子 

分 类 号：R737.14[医药卫生—肿瘤]