儿童肺炎支原体肺炎TIPE2、TLR2及TLR4表达及意义  

Expression and significance of TIPE2,TLR2 and TLR4 in children with Mycoplasma pneumoniae pneumonia

作　　者：高阳[1] 贺琳晰[1] 赵璠[1] 马冬[1] 由凯[1] GAO Yang;HE Lin-xi;ZHAO Fan;MA Dong;YOU Kai(Shengjing Hospital Affiliated to China Medical University,Shenyang,Liaoning 110004,China)

机构地区：[1]中国医科大学附属盛京医院小儿重症监护病房,辽宁沈阳110004

出　　处：《中华医院感染学杂志》2022年第15期2373-2377,共5页Chinese Journal of Nosocomiology

基　　金：辽宁省科研基金资助项目(2019LN121)。

摘　　要：目的探讨肿瘤坏死因子α诱导蛋白8样因子2(TIPE2)、Toll样受体2(TLR2)及Toll样受体4(TLR4)在肺炎支原体肺炎(MPP)患儿外周血的表达及其临床意义。方法收集2019年1月-2020年12月中国医科大学附属盛京医院收治的MPP患儿80例,根据病情严重程度分为轻症MPP组52例和重症MPP组28例,另收集同期健康体检儿童30例为对照组;采集三组的空腹静脉血,分离外周血单个核细胞并检测TIPE2、TLR2及TLR4 mRNA表达;MPP患儿入院后完善血常规、C-反应蛋白(CRP)及降钙素原(PCT)等实验室检查;采用受试者工作特征(ROC)曲线评价TIPE2、TLR2及TLR4评估轻、重症MPP的应用价值。结果重症MPP组发热、肺内外并发症发生率高于轻症MPP组(P<0.05)。重症MPP组白细胞(WBC)计数及PCT水平与轻症MPP组比较无统计学差异,CRP和中性粒细胞水平均高于轻症MPP组(P<0.05),血小板(PLT)计数低于轻症MPP组(P<0.05)。重症MPP组和轻症MPP组TLR2、TLR4 mRNA水平均高于轻症MPP组(P<0.05),TIPE2 mRNA水平低于对照组(P<0.05);重症MPP组TLR2、TLR4 mRNA水平高于轻症MPP组(P<0.05),TIPE2 mRNA水平低于轻症MPP组(P<0.05)。TIPE2、TLR2、及TLR4三者联合评估轻、重症MPP的AUC分别高于各指标单独评估的AUC(P<0.05)。结论重症MPP患儿PBMCs中TLR2及TLR4表达水平明显上调,TIPE2水平下调,此三者联合检测有助于识别重症MPP。OBJECTIVE To explore the expression and clinical significance of peripheral blood tumor necrosis factor-α-inducible protein 8-like molecule 2(TIPE2),Toll-like receptor 2(TLR2)and Toll-like receptor 4(TLR4)in children with Mycoplasma pneumoniae pneumonia(MPP).METHODS A total of 80 children with MPP admitted to Shengjing Hospital Affiliated to China Medical University between Jan 2019 and Dec 2020 were enrolled.According to disease severity,they were divided into the mild MPP group(52 cases)and severe MPP group(28 cases).Another 30 healthy children under physical examination during the same period were enrolled as the control group.The fasting venous blood from the three groups was collected,and peripheral blood mononuclear cells(PBMCs)were isolated to detect the mRNA expression of TIPE2,TLR2 and TLR4.After admission,laboratory examinations including blood routine,C-reactive protein(CRP),procalcitonin(PCT)in MPP children were performed.The application value of TIPE2,TLR2 and TLR4 in evaluating mild and severe MPP was assessed by receiver operating characteristic(ROC)curves.RESULTS The incidence of fever,intrapulmonary and extrapulmonary complications in the severe MPP group was higher than those in the mild MPP group(P<0.05).There was no significant difference in white blood cell(WBC)count and PCT between the severe MPP group and mild MPP group.The levels of CRP and neutrophils in the severe MPP group were higher than those in the mild MPP group(P<0.05),while platelet(PLT)count was lower than that in the mild MPP group(P<0.05).The levels of TLR2 and TLR4 mRNA in the severe MPP group and mild MPP group were higher than those in the control group(P<0.05),while level of TIPE2 mRNA was lower than that in the control group(P<0.05).The levels of TLR2 and TLR4 mRNA in the severe MPP group were higher than those in the mild MPP group(P<0.05),while level of TIPE2 mRNA was lower than that in the mild MPP group(P<0.05).AUC of TIPE2 combined with TLR2 and TLR4 for evaluating mild and severe MPP was larger than that of individ

关 键 词：肺炎 肺炎支原体 肿瘤坏死因子α诱导蛋白8样因子2 TOLL样受体2 TOLL样受体4 

分 类 号：R725.6[医药卫生—儿科]