红细胞膜表面TLR9表达在脓毒症相关性贫血中的临床价值  

Role of TLR9 of red blood cell membrane surface in sepsis patients with anemia

作　　者：蒙强 王双[1] 白舟 黄茜[1] 付阳[1] MENG Qiang;WANG Shuang;BAI Zhou;HUANG Qian;FU Yang(Department of Clinical Laboratory,West China Hospital of Sichuan University,Chengdu 610041,Sichuan,China)

机构地区：[1]四川大学华西医院实验医学科,四川成都610041

出　　处：《检验医学》2024年第10期933-938,共6页Laboratory Medicine

基　　金：国家自然科学基金项目(82002215);四川省自然科学基金项目(2023NSFSC1483)。

摘　　要：目的 探讨脓毒症患者外周血红细胞(RBC)膜表面Toll样受体(TLR)9表达在脓毒症相关性贫血中的临床价值。方法 选取2022年7月—2023年5月四川大学华西医院脓毒症患者237例(脓毒症组)、普通感染患者241例(普通感染组)和健康体检者206名(正常对照组)。收集所有研究对象的临床资料和脓毒症诊断24 h内的19项RBC相关参数检测结果。检测46例脓毒症患者、35例普通感染患者和28名健康体检者外周血RBC膜表面TLR9的表达情况。采用Spearman相关分析评估TLR9表达与RBC相关参数之间的相关性。结果脓毒症组RBC计数、血红蛋白(Hb)、平均红细胞血红蛋白浓度(MCHC)、网织红细胞绝对数(RET#)、网织红细胞血红蛋白(RET-He)、网织通道红细胞计数(RBC-O)、网织通道RET区域前向散射光强度(RET-Y)均显著低于普通感染组(P<0.05),红细胞平均体积(MCV)、红细胞体积分布宽度-标准差(RDW-SD)、红细胞体积分布宽度-变异系数(RDW-CV)、高荧光强度网织红细胞比例(HFR)均显著高于普通感染组(P<0.05)。脓毒症组TLR9+RBC百分比高于普通感染组(P<0.01)。TLR9+RBC百分比与RBC计数、Hb、RET#、RBC-O、MCHC、RET-He、RET-Y呈负相关(P<0.01),与RDW-SD、RDW-CV呈正相关(P<0.001)。结论 脓毒症患者RBC膜表面TLR9表达增加。高表达的TLR9与严重的贫血程度、低下的红系造血能力和异常的红细胞形态密切相关。Objective To investigate the role of Toll-like receptor(TLR)9 expression on the membrane surface of red blood cell(RBC)in sepsis patients with anemia.Methods A total of 237 sepsis patients(sepsis group),241 patients with local infections(local infection group)and 206 healthy subjects(healthy control group)at West China Hospital of Sichuan University from July 2022 to May 2023 were enrolled.The clinical data and 19 RBC-related parameters within 24 h of sepsis diagnosis were collected.The expressions of TLR9 on peripheral blood RBC membrane surface in 46 sepsis patients,35 common infection patients and 28 healthy subjects were determined simultaneously.The correlation between TLR9 and RBC-related parameters was assessed using Spearman analysis.Results The sepsis group had lower levels of RBC count,hemoglobin(Hb),mean corpuscular hemoglobin concentration(MCHC),the absolute value of reticulocyte(RET#),reticulocyte-hemoblobin(RET-He),red blood cell-O(RBC-O)and reticulocyte-Y(RET-Y)compared to local infection group(P<0.05).The sepsis group had higher levels of mean corpuscular volume(MCV),red blood cell volume distribution width-standard deviation(RDW-SD),red blood cell volume distribution width-coefficient of variation(RDW-CV)and highfluorescence ratio(HFR)compared to local infection group(P<0.05).The percentage+of TLR9 RBC in peripheral blood of sepsis group was higher than that in local infection group(P<0.01).The+percentage of TLR9 RBC was negatively correlated with RBC count,Hb,RET#,RBC-O,MCHC,RET-+He and RET-Y(P<0.01).The percentage of TLR9 RBC was positively correlated with RDW-SD and RDW-CV(P<0.001).Conclusions The expression of TLR9 in RBC membrane surface of sepsis patients is increased,and the high expression of TLR9 is related to the degree of severe inflammatory anemia,low RBC hematopoietic ability and greater RBC morphological abnormality.

关 键 词：TOLL样受体9 红细胞参数 脓毒症 贫血 

分 类 号：R446.62[医药卫生—诊断学]