不同EB病毒感染状态下PNS儿童外周血Toll样受体-2、-4、-6表达及意义  

Expression levels of Toll-like receptor-2,-4 and-6 in children with PNS under different EB virus infection status and their significance

作　　者：邢二庆 刘玉霞[1] 尚家星 王成祥[1] 李志萍[1] 王向华 谢遂亮 XING Er-qing;LIU Yu-xia;SHANG Jia-xing;WANG Cheng-xiang;LI Zhi-ping;WANG Xiang-hua;XIE Sui-liang(Xinxiang Central Hospital,Xinxiang,Henan 453000,China)

机构地区：[1]新乡市中心医院儿一科,河南新乡453000 [2]新乡市中心医院心内一科,河南新乡453000

出　　处：《中华医院感染学杂志》2022年第21期3336-3340,共5页Chinese Journal of Nosocomiology

基　　金：河南省医学科技攻关计划联合共建基金资助项目(LHGJ20191318)。

摘　　要：目的探讨不同EB病毒(EBV)感染状态下原发性肾病综合征(PNS)儿童外周血单个核细胞中Toll样受体(TLR)-2、TLR-4、TLR-6表达水平及意义。方法选取2017年10月-2022年3月新乡市中心医院130例PNS儿童,其中89例合并EBV感染的患儿为感染组,41例未合并EBV感染的患儿为未感染组,同时依照EBV感染状态将感染组患儿分为潜伏感染组(n=57)、活动性感染组(n=32)两个亚组,比较不同组别外周血单个核细胞中TLR-2、TLR-4、TLR-6 mRNA水平,通过受试者工作曲线(ROC)评价三项指标对疾病的诊断评估价值,对比不同感染状态下患儿肾功能损伤情况。结果感染组PNS儿童外周血单个核细胞中TLR-2、TLR-4、TLR-6 mRNA表达水平低于未感染组(P<0.05);TLR-2、TLR-4、TLR-6联合检测对PNS患儿是否合并EBV感染评估ROC曲线下面积为0.832高于三项指标单独检测(P<0.05);活动性感染组PNS儿童TLR-2、TLR-4、TLR-6 mRNA表达低于潜伏感染组(P<0.05);TLR-2、TLR-4、TLR-6联合检测对患儿EBV感染潜伏和活动性评估ROC曲线下面积为0.848高于三项指标单独检测8(P<0.05);未感染组、潜伏感染组、感染组尿液中性粒细胞明胶酶相关脂笼蛋白(NGAL)、肾损伤分子(KIM-1)水平比较,无统计学差异。结论EBV感染患儿TLR-2、TLR-4、TLR-6表达被抑制,且活动性感染组TLR-2、TLR-4、TLR-6表达水平低于潜伏感染组。OBJECTIVE To explore the expression levels of Toll-like receptor-2(TLR-2),Toll-like receptor-4(TLR-4)and Toll-like receptor-6(TLR-6)in peripheral blood mononuclear cells(PBMCs)of children with primary nephrotic syndrome(PNS)under different Epstein-Barr virus(EBV)infection status and analyze the significance.METHODS A total of 130 children with PNS who were treated in Xinxiang Central Hospital from Oct 2017 to Mar 2022 were enrolled in the study,89 of whom were complicated with EBV infection and assigned as the infection group,and 41 were not complicated with EBV infection and assigned as the no infection group.The children of the infection group were divided into two subgroups based on the status of EBV infection:the latent infection group with 57 cases and the active infection group with 32 cases.The levels of TLR-2,TLR-4 and TLR-6 mRNA in PBMCs were compared between the different types of groups,the values of the three indexes in diagnosis and assessment of disease were evaluated by receiver operating characteristic(ROC)curve,and the status of renal function damage was observed and compared among the children under different states of infection.RESULTS The expression levels of TLR-2,TLR-4 and TLR-6 mRNA in PBMCs of the children with PNS were lower in the infection group than in the no infection group(P<0.05).The area under receiver operating characteristic(ROC)curve of the joint detection of TLR-2,TLR-4 and TLR-6 was 0.832 in assessment of EBV infection in the children with PNS,larger than that of the single detection of the three indexes(P<0.05).The expression levels of TLR-2,TLR-4 and TLR-6 mRNA of the children with PNS were higher in the active infection group than in the latent infection group(P<0.05).The area under ROC curve of the joint detection of TLR-2,TLR-4 and TLR-6 was 0.848 in assessment of latent and active EBV infection,higher than that of the single detection of the three indexes(P<0.05).There were no significant differences in the levels of urine neutrophil gelatinase-associated lipocalin(NGAL)

关 键 词：原发性肾病综合征 EB病毒感染 儿童 外周血单个核细胞 TOLL样受体 临床意义 

分 类 号：R726.9[医药卫生—儿科]