MyD88和TRIF在新生儿脑损伤中的表达及其与炎症反应的关系  

Expression of MyD88 and TRIF in neonatal brain injury and their relationship with inflammatory response

作　　者：庄玮清 季晓云[1] ZHUANG Wei-qing;JI Xiao-yun(Department of Door Emergency,The Affiliated Obstetrics and Gynecology Hospital of Tongji University,Shanghai 200040,China)

机构地区：[1]同济大学附属妇产科医院门急诊科,上海200040

出　　处：《临床和实验医学杂志》2024年第19期2085-2089,共5页Journal of Clinical and Experimental Medicine

基　　金：上海市自然科学基金项目辅助项目(编号:20ZR1443900)。

摘　　要：目的探讨髓样分化因子88(MyD88)和β干扰素TIR结构域衔接蛋白(TRIF)在新生儿脑损伤中的表达及其与炎症反应的关系。方法前瞻性选取2021年10月至2023年9月入同济大学附属妇产科医院诊断并接受治疗的新生儿脑损伤患儿103例为研究对象,作为新生儿损伤组。同时选择同期无神经系统疾病的正常新生儿80例,作为对照组。收集所有新生儿的临床资料,并采集外周静脉血3 mL,检测两组新生儿血清中降钙素原、肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-2、IL-1β、IL-8和IL-6水平,采用实时荧光定量PCR检测血清中MyD88和TRIF mRNA表达,采用Pearson相关性分析对MyD88和TRIF mRNA表达与炎症反应的关系进行分析,并采用受试者操作特征(ROC)曲线评估MyD88和TRIF mRNA表达在新生儿脑损伤中的诊断价值。结果两组新生儿的胎龄、年龄、出生体重、男性占比、生产方式比较,差异均无统计学意义(P>0.05);脑损伤组Apgar评分为(7.42±1.87)分,明显低于对照组[(8.78±4.72)分],差异有统计学意义(P<0.05)。脑损伤组新生儿血清降钙素原、TNF-α、IL-1β、IL-2、IL-8和IL-6水平分别为(6.21±0.73)ng/L、(5.94±1.83)pg/mL、(8.93±2.95)pg/mL、(3.17±1.02)pg/mL、(32.98±9.83)pg/mL、(14.51±4.37)pg/mL,均明显高于对照组[(0.59±0.18)ng/L、(2.68±0.79)pg/mL、(4.19±1.36)pg/mL、(1.29±0.73)pg/mL、(7.37±2.91)pg/mL、(2.97±0.85)pg/mL],差异均有统计学意义(P<0.05)。脑损伤组新生儿血清中MyD88和TRIF mRNA表达水平分别为2.46±0.73、2.11±0.65,均明显高于对照组(1.03±0.29、0.79±0.22),差异均有统计学意义(P<0.05)。MyD88和TRIF mRNA表达均与炎症反应指标降钙素原、TNF-α、IL-1β、IL-2、IL-8和IL-6均呈正相关(P<0.05)。血清MyD88 mRNA检测诊断新生儿脑损伤的最佳临界值为1.561,敏感度和特异度分别为77.50%和86.25%,ROC曲线下面积(AUC)为0.868(95%CI:0.804~0.932);血清TRIF mRNA检测诊断新生儿脑损伤的最佳临界值为Objective To investigate the expression of myeloid differentiation factor 88(MyD88)and beta interferon TIR domain adaptor protein(TRIF)in neonatal brain injury and the relationship between TRIF and inflammation.Methods A total of 103 children with neonatal brain injury who were diagnosed and treated in the Affiliated Hospital of Obstetrics and Gynecology of Tongji University from October 2021 to September 2023 were selected as the study objects and were selected as the neonatal brain injury group.At the same time,80 normal newborns without neurological diseases were selected as the control group.Clinical data of all neonates were collected,3 mL peripheral venous blood was collected,and serum levels of procalcitonin,tumor necrosis factorα(TNF-α),interleukin(IL)-2,IL-1β,IL-8 and IL-6 were detected.The expression of MyD88 and TRIF mRNA in serum was detected using real-time fluorescent quantitative PCR.The relationship between MyD88 and TRIF mRNA expression and inflammatory response was analyzed by Pearson correlation analysis.And the diagnostic value of MyD88 and TRIF mRNA expression in neonatal brain injury was evaluated by receiver operating characteristic(ROC)curve.Results There were no statistically significant differences in gestational age,age,birth weight,male proportion and mode of production between the two groups(P>0.05);the Apgar score of the neonatal brain injury group was(7.42±1.87)points,which was significantly lower than that of the control group[(8.78±4.72)points],the difference was statistically significant(P<0.05).The levels of serum procalcitonin,TNF-α,IL-1β,IL-2,IL-8 and IL-6 in the neonatal brain injury group were(6.21±0.73)ng/L,(5.94±1.83)pg/mL,(8.932.95)pg/mL,(3.17±1.02)pg/mL,(32.98±9.83)pg/mL,(14.51±4.37)pg/mL,respectively.They were significantly higher than those in the control group[(0.59±0.18)ng/L,(2.68±0.79)pg/mL,(4.19±1.36)pg/mL,(1.29±0.73)pg/mL,(7.37±2.91)pg/mL,(2.97±0.85)pg/mL],the differences were statistically significant(P<0.05).The expression levels of MyD88 and T

关 键 词：脑损伤 髓样分化因子88 新生儿 β干扰素TIR结构域衔接蛋白 炎症反应 相关性 诊断价值 

分 类 号：R722.1[医药卫生—儿科] R446.1[医药卫生—临床医学]