MRSA感染SP患者T细胞亚群及TLR4、TLR2、TP、ALB诊断价值  

Analysis of T cell subsets and TLR4,TLR2,TP,ALB in SP patients infected with MRSA

作　　者：蒲发晓 任婷远 张宇 PU Faxiao;REN Tingyuan;ZHANG Yu(Department of Laboratory Medicine,Zhangye People’s Hospital Affiliated to Hexi University,Zhangye,Gansu,China,734000;Department of Pathology,Zhangye People’s Hospital Affiliated to Hexi University,Zhangye,Gansu,China,734000)

机构地区：[1]河西学院附属张掖人民医院检验科,甘肃张掖734000 [2]河西学院附属张掖人民医院病理科,甘肃张掖734000

出　　处：《分子诊断与治疗杂志》2024年第7期1246-1250,共5页Journal of Molecular Diagnostics and Therapy

基　　金：甘肃省教育厅高校教师创新基金项目(2024A-154);张掖市市级科技计划项目(ZY2023BJ15)。

摘　　要：目的 探讨耐甲氧西林金黄色葡萄球菌(MRSA)感染重症肺炎(SP)患者外周血T细胞亚群变化,并分析外周血Toll样受体4(TLR4)、Toll样受体2(TLR2)及血清总蛋白(TP)、白蛋白(ALB)联合检测对其的诊断价值。方法 于2020年1月至2022年12月从河西学院附属张掖人民医院选取MRSA感染SP患者179例为感染组,另选MRSA未感染SP患者181例为对照组。分析MRSA耐药情况,比较两组外周血T细胞亚群、TLR4、TLR2及血清TP、ALB水平,并分析外周血TLR4、TLR2、血清TP、ALB诊断MRSA感染SP的价值。结果 MRSA耐药率较高的抗菌药物包括青霉素、苯唑西林、红霉素、克林霉素、四环素、环丙沙星;完全敏感的抗菌药物包括替加环素、呋喃妥因、利奈唑胺、奎努普汀。较对照组,感染组外周血CD19^(+)、TLR4、TLR2水平更高(t=15.378、13.408、12.113,P<0.05);外周血CD4^(+)、CD3^(+)、CD4^(+)/CD8^(+)及血清TP、ALB水平更低(t=23.295、26.320、17.810,P<0.05)。以感染组为阳性,对照组为阴性绘制ROC曲线进行分析,结果显示血清TLR4、TLR2、TP、ALB联合检测诊断MRSA感染SP的曲线下面积(AUC)值高于四者单一检测(P<0.05)。结论 MRSA感染SP患者外周血T细胞亚群异常变化,且外周血TLR4、TLR2呈高表达,血清TP、ALB呈低表达,四者联合检测的诊断价值更高。Objective To investigate the changes of peripheral blood T-lymphocyte subpopula-tions in patients with methicillin-resistant staphylococcus aureus(MRSA)infected severe pneumonia(SP)and to analyze the diagnostic value of the combined peripheral blood toll-like receptor 4(TLR4),toll-like receptor 2(TLR2),and serum total protein(TP),albumin(ALB)assay for their diagnosis.Methods From January 2020 to December 2022,179 cases of MRSA infected SP patients were selected from Zhangye People’s Hospi-tal affiliated with Hexi College as the infected group,and another 181 cases of MRSA uninfected SP patients were selected as the control group.The drug resistance of MRSA was analyzed,the levels of peripheral blood T lymphocyte subpopulations,TLR4,TLR2,and serum TP and ALB between the two groups were compared,and the value of peripheral blood TLR4,TLR2,serum TP,and ALB for diagnosis of MRSA infection with SP was analyzed.Results Antimicrobial drugs with high MRSA resistance rates include penicillin,benzoxiline,erythromycin,clindamycin,tetracycline,and ciprofloxacin.Antimicrobial drugs with complete sensitivity in-clude tigecycline,furotoxin,linezolid,and quinupristin.In comparison with the control group,peripheral blood CD19^(+),TLR4,and TLR2 levels were higher in the infected group(t=15.378,13.408,and 12.113,P<0.05),while levels of CD4^(+),CD3^(+),CD4^(+)/CD8^(+),and serum TP and ALB were lower(t=23.295,26.320,and 17.810,P<0.05).The ROC curve was plotted and analyzed with the infected group as positive and the control group as negative.The results showed that the area under the curve(AUC)value of serum TLR4,TLR2,TP,and ALB combined test for diagnosis of MRSA infected SP was 0.932,which was higher than that of the four single tests(0.811,0.861,0.865,and 0.849,P<0.05).Conclusion Patients with MRSA-in-fected SP had abnormal changes in peripheral blood T-lymphocyte subpopulations and high expression of peripheral blood TLR4 and TLR2.Additionally,they showed low expression of serum TP and ALB.The com-bined detection of the four ma

关 键 词：耐甲氧西林金黄色葡萄球菌 重症肺炎 T细胞亚群 Toll样受体4 TOLL样受体2 总蛋白 白蛋白 

分 类 号：R563.1[医药卫生—呼吸系统]