肺癌伴感染性发热患者外周血单个核细胞 TLR4及TLR2基因表达的检测价值  

Values of TLR4 and TLR2 gene expressions in peripheral blood mononuclear cells of lung cancer patients with infectious fever

作　　者：芦山 王换 王慧慧 张超玲[3] 杨淑玲[4] LU Shan;WANG Huan;WANG Hui-hui;ZHANG Chao-ling;YANG Shu-ling(Puyang Medical Vocational School,Puyang,Henan 457000,China;不详)

机构地区：[1]濮阳医学高等专科学校护理系,河南濮阳457000 [2]濮阳市第五人民医院结核科,河南濮阳457000 [3]焦作煤业(集团)中央医院眼科,河南焦作454150 [4]焦作市人民医院心内科,河南焦作454150

出　　处：《中华医院感染学杂志》2023年第16期2453-2457,共5页Chinese Journal of Nosocomiology

基　　金：河南省自然科学基金资助项目(2019071)。

摘　　要：目的 分析肺癌伴感染性发热患者外周血单个核细胞(PBMC)Toll样受体4(TLR4)、Toll样受体2(TLR2)基因表达变化。方法 选择2019年1月-2021年1月医院收治的肺癌患者900例为研究对象,根据是否合并感染性发热,将患者分为感染性发热组(n=163)和非感染性发热组(n=737)。分析肺癌伴感染性发热患者的病原菌检出情况。采用实时荧光定量聚合酶链式反应法检测患者PBMC中TLR4、TLR2基因表达水平。采用酶联免疫吸附试验法检测患者血清炎性因子肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-1β、IL-6和IL-8水平。结果 163例肺癌伴感染性发热患者共检出病原菌172株,其中革兰阴性菌113株(65.70%),革兰阳性菌59株(34.30%);感染性发热组患者PBMC中TLR4、TLR2 mRNA表达水平以及血清TNF-α、IL-1β、IL-6和IL-8水平均高于非感染性发热组患者(P<0.05);感染性发热患者治疗后PBMC中TLR4、TLR2 mRNA表达水平以及血清炎性因子TNF-α、IL-1β、IL-6和IL-8水平均低于治疗前(P<0.05);Logistic多因素回归分析显示,TLR4 mRNA、TLR2 mRNA、TNF-α、IL-1β、IL-6、IL-8均为肺癌患者并发感染性发热的独立影响因素(P<0.05)。结论肺癌伴感染性发热患者感染病原菌以革兰阴性菌为主,临床上可根据病原菌种类合理选择抗菌药物。患者PBMC中TLR4、TLR2基因上调表达,TLR4、TLR2可能参与了肺癌伴感染性发热的发生发展过程,检测TLR4、TLR2基因表达变化有助于为肺癌伴感染性发热的辅助诊断和治疗提供参考。OBJECTIVE To analyze the changes in Toll-like receptor 4(TLR4)and Toll-like receptor 2(TLR2)gene expressions in peripheral blood mononuclear cells(PBMCs)of patients with lung cancer and infectious fever.METHODS A total of 900 patients with lung cancer admitted to the hospital between Jan 2019 and Jan 2021 were selected as the research subjects,and were divided into infectious fever group(n=163)and non-infectious fever group(n=737)according to whether they were complicated with infectious fever.The status of pathogenic bacteria detected among patients with lung cancer and infectious fever were analyzed.The gene expression levels of TLR4 and TLR2 in PBMCs of patients were detected by real-time fluorescence quantitative polymerase chain reaction(PCR).Serum levels of inflammatory factors such as TNF-α,IL-1β,IL-6 and IL-8 were detected by enzyme-linked immunosorbent assay(ELISA).RESULTS A total of 172 strains of pathogenic bacteria were detected among 163 patients with lung cancer complicated with infectious fever,including 113 strains(65.70%)of gram-negative bacteria and 59 strains(34.30%)of gram-positive bacteria.The mRNA expression levels of TLR4 and TLR2 in PBMC and serum levels of tumor necrosis factor-α(TNF-α),interleukin(IL)-1β,IL-6 and IL-8 were higher in patients in the infectious fever group than in those in the non-infectious fever group(P0.05).The expression levels of TLR4 mRNA and TLR2 mRNA in PBMCs and levels of serum inflammatory factors of TNF-α,IL-1β,IL-6 and IL-8 in patients with infectious fever after treatment were lower than those before treatment(P0.05).Logistic multivariate regression analysis showed that TLR4 mRNA,TLR2 mRNA,TNF-α,IL-1β,IL-6 and IL-8 were independent influencing factors for lung cancer patient with concurrent infectious fever(P<0.05).CONCLUSION The pathogenic bacteria in patients with lung cancer complicated with infectious fever were mainly gram-negative bacteria.Clinically,antibacterial drugs can be selected appropriately according to the types of pathogenic bacteria.

关 键 词：肺癌 感染性发热 外周血单个核细胞 TOLL样受体4 TOLL样受体2 

分 类 号：R734.2[医药卫生—肿瘤]