VAP患者WISP1/TLR4/整合素β5通路基因及相关炎性因子的表达  

Expression of WISP1/TLR4/integrin β5 pathway genes and related inflammatory factors in VAP patients

作　　者：章娟琪 孙雪东[1] 姚晓燕 池虹漪 严一核[1] ZHANG Juan-qi;SUN Xue-dong;YAO Xiao-yan;CHI Hong-yi;YAN Yi-he(Shaoring People's Hospital,Shaoxing,Zhejiang 312000,China)

机构地区：[1]绍兴市人民医院重症医学科,浙江绍兴312000

出　　处：《中华医院感染学杂志》2022年第9期1290-1294,共5页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技计划基金资助项目(2021418982)。

摘　　要：目的 探究Wnt1-诱导的信号通路蛋白1(WISP1)/Toll样受体4(TLR4)/整合素β5通路基因及肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6、IL-8在呼吸机相关性肺炎(VAP)患者中的表达。方法 选取2018年4月-2021年3月绍兴市人民医院收治的120例VAP患者(VAP组)及60例机械通气非VAP患者(对照组),统计VAP患者病原菌分布;比较两组外周血单个核细胞WISP1、TLR4、整合素β5 mRNA相对表达量及血清TNF-α、IL-6、IL-8水平;绘制受试者工作特征曲线(ROC)分析相关指标预测VAP患者28 d死亡的临床价值。结果 120例患者分离出156株病原菌,革兰阴性菌、革兰阳性菌、真菌分别占51.92%、36.54%、11.54%。VAP组外周血单个核细胞中WISP1、TLR4、整合素β5相对表达量以及血清TNF-α、IL-6、IL-8表达水平较对照组均升高(P<0.05)。VAP组死亡患者外周血单个核细胞中WISP1、TLR4 mRNA相对表达量以及血清TNF-α、IL-6表达水平较存活组均升高(P<0.05)。WISP1 mRNA、TLR4 mRNA、TNF-α、IL-6预测VAP患者28 d死亡的ROC曲线下面积分别为0.886、0.795、0.644、0.876。结论 VAP患者WISP1/TLR4/整合素β5通路激活及相关炎性因子TNF-α、IL-6、IL-8水平升高,WISP1 mRNA、TLR4 mRNA、TNF-α、IL-6对VAP患者预后有一定预测价值。OBJECTIVE To explore the expression of Wnt1-inducible signaling pathway protein 1(WISP1)/Toll-like receptor 4(TLR4)/integrin β5 pathway genes and related inflammatory factors tumor necrosis factor-α(TNF-α), interleukin-6(IL-6) and interleukin-8(IL-8) in patients with ventilator-associated pneumonia(VAP). METHODS A total of 120 patients with VAP who were treated in Shaoxing People′s Hospital from Apr 2018 to Mar 2021 were assigned as the VAP group, and 60 patients who underwent mechanical ventilation but did not have VAP were chosen as the control group. The distribution of pathogens isolated from the VAP patients was statistically analyzed, the relative expression levels of WISP1, TLR4 and integrin β5 mRNA in peripheral blood mononuclear cells and levels of serum TNF-α, IL-6 and IL-8 were compared between the two groups, and the clinical values of related indexes in prediction of 28-day mortality were analyzed by using receiver operating characteristic(ROC) curve. RESULTS Totally 156 strains of pathogens were isolated from the 120 patients;the gram-negative bacteria, the gram-positive bacteria and the fungi accounted for 51.92%, 36.54% and 11.54%, respectively. The relative expression levels of WISP1, TLR4 and integrin β5 in peripheral blood mononuclear cells and levels of serum TNF-α, IL-6 and IL-8 were significantly significantly higher in the VAP group than in the control group(P<0.05). In the VAP group, the relative expression levels of WISP1, TLR4 and integrin β5 in peripheral blood mononuclear cells and levels of serum TNF-α, IL-6 and IL-8 of the dead patients were significantly higher than those of the survived patients(P<0.05). The areas under ROC curves of WISP1 mRNA, TLR4 mRNA, TNF-α and IL-6 were respectively 0.886, 0.795, 0.644 and 0.876 in prediction of 28-day mortality of the VAP patients. CONCLUSION The expression levels of WISP1/TLR4/integrin β5 and related inflammatory factors TNF-α, IL-6 and IL-8 of the VAP patients are elevated. The WISP1 mRNA, TLR4 mRNA, TNF-α and IL-6 have cert

关 键 词：呼吸机相关性肺炎 Wnt1-诱导的信号通路蛋白1 TOLL样受体4 整合素β5 基因表达 炎症因子 预后 

分 类 号：R561.3[医药卫生—呼吸系统]