卵巢癌患者化疗后骨髓抑制并发肺部感染病原菌特点及与外周血单核细胞Nrf2 mRNA和TLR7 mRNA的相关性  

Characteristics of pathogenic bacteria of pulmonary infection in ovarian cancer patients with post-chemotherapy bone marrow suppression and the correlation with expression of Nrf2 mRNA and TLR7 mRNA in peripheral blood mononuclear cells

作　　者：王英[1] 徐燕 叶永生[1] WANG Ying;XU Yan;YE Yongsheng(Gynecology Department,Nanyang Central Hospital,Nanyang,He’nan 473000,China;不详)

机构地区：[1]南阳市中心医院妇科,河南473000

出　　处：《中国微生态学杂志》2024年第3期341-345,350,共6页Chinese Journal of Microecology

摘　　要：目的观察卵巢癌患者化疗后骨髓抑制并发肺部感染病原菌特点,并分析其与外周血单核细胞(PBMC)Nrf2 mRNA、TLR7 mRNA表达的相关性。方法选取我院30例化疗后骨髓抑制并发肺部感染的卵巢癌患者(并发肺部感染组)及同期30例化疗后骨髓抑制无肺部感染的卵巢癌患者(未并发肺部感染组)为研究对象,观察并发肺部感染患者病原菌特点,检测两组患者化疗后PBMC Nrf2 mRNA、TLR7 mRNA的表达水平,分析Nrf2 mRNA、TLR7 mRNA与骨髓抑制的关系及Nrf2 mRNA、TLR7 mRNA对骨髓抑制并发肺部感染的预测价值。结果共检出病原菌30株,其中革兰阳性菌12株(40.00%),革兰阴性菌18株(60.00%),且以铜绿假单胞菌为主(20.00%)。白细胞减少0~Ⅰ度患者、中性粒细胞减少0~Ⅰ度患者Nrf2 mRNA水平显著高于白细胞减少Ⅱ~Ⅲ度患者和中性粒细胞减少Ⅱ~Ⅲ度患者,而TLR7 mRNA水平显著低于白细胞减少Ⅱ~Ⅲ度患者和中性粒细胞减少Ⅱ~Ⅲ度患者(均P<0.05)。白细胞减少、中性粒细胞减少与Nrf2 mRNA表达水平呈负相关,与TLR7 mRNA表达水平呈正相关(均P<0.05)。并发肺部感染组患者Nrf2 mRNA水平显著低于未并发肺部感染组,而TLR7 mRNA水平显著高于未并发肺部感染组(均P<0.05)。Nrf2 mRNA对骨髓抑制并发肺部感染预测的敏感度为80.2%,特异度为71.3%;TLR7 mRNA的敏感度为83.5%,特异度为70.9%;两者联合预测的敏感度为88.4%,特异度为78.6%。结论卵巢癌患者化疗后骨髓抑制与PBMC Nrf2 mRNA、TLR7 mRNA存在显著联系。骨髓抑制并发肺部感染的病原菌以革兰阴性菌为主,患者PBMC Nrf2 mRNA水平显著降低,TLR7 mRNA水平显著升高,两者联合检测对骨髓抑制并发肺部感染具有较高的预测价值。Objective To observe the characteristics of pathogenic bacteria of pulmonary infection in ovarian cancer(OC)patients with post-chemotherapy bone marrow suppression(BMS),and the correlation with the expression of Nrf2 mRNA and TLR7 mRNA in peripheral blood mononuclear cells(PBMC).Methods A total of 30 OC patients with postchemo BMS and pulmonary infection(pulmonary infection group),and 30 ones with post-chemo BMS but no pulmonary infection(non-pulmonary infection group)were included in the study.The characteristics of pathogenic bacteria in the patients with pulmonary infection were observed.The expression levels of Nrf2 mRNA and TLR7 mRNA in peripheral blood mononuclear cells in the two groups after chemotherapy were detected.The relationship of Nrf2 mRNA and TLR7 mRNA with BMS,as well as the predictive values of Nrf2 mRNA and TLR7 mRNA for BMS complicated with pulmonary infec-tion were analyzed.Results A total of 30 pathogenic bacterial strains were detected,including 12(40.00%)strains of Gram positive bacteria and 18(60.00%)strains of Gram negative bacteria,with Pseudomonas aeruginosa being dominant pathogen(20.00%).The Nrf2 mRNA levels in the patients with grade 0-Ⅰleukopenia and those with grade 0-Ⅰneutropenia were significantly higher(all P<0.05),while the TLR7 mRNA levels were significantly lower than those in the patients with gradeⅡ-Ⅲleukopenia and those with gradeⅡ-Ⅲneutropenia,respectively(all P<0.05).Leukopenia and neutropenia were negatively correlated with Nrf2 mRNA expressions,but positively correlated with TLR7 mRNA expression(all P<0.05).Nrf2 mRNA level in the pulmonary infection group was significantly lower,while TLR7 mRNA level was significantly higher than those in the non-pulmonary infection group,respectively(all P<0.05).The sensitivity and specificity of Nrf2 mRNA,TLR7 mRNA,and the combination of both for predicting BMS complicated with pulmonary infection were 80.2%and 71.3%,83.5%and 70.9%,and 88.4%and 78.6%,respectively.Conclusion BMS is closely related to Nrf2 mRNA and TLR7 m

关 键 词：卵巢癌 骨髓抑制 肺部感染 核因子E2相关因子2 TOLL样受体7 

分 类 号：R737.31[医药卫生—肿瘤]