血清TLR4对新生儿呼吸窘迫综合征的诊断价值及其与常见炎性细胞因子的关系  

The Diagnostic Value of Serum TLR4 in Neonatal Respiratory Distress Syndrome and Its Relationship with Common Inflammatory Cytokines

作　　者：张晋雷[1] 张静[2] 杨英阁[1] ZHANG Jinlei;ZHANG Jing;YANG Yingge(Pediatric Ward One,The First Affiliated Hospital of Nanyang Medical College,Nanyang 473058,He’nan Province,China;Medical Laboratory Department,The First Affiliated Hospital of Nanyang Medical College)

机构地区：[1]南阳医学高等专科学校第一附属医院儿科一病区,河南南阳473058 [2]南阳医学高等专科学校第一附属医院医学检验科,河南南阳473058

出　　处：《中国实用乡村医生杂志》2025年第2期75-78,共4页Chinese Practical Journal of Rural Doctor

基　　金：南阳市2022年科技计划项目,项目编号:KJGG071。

摘　　要：目的探讨血清TLR4对新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS)的诊断价值及与常见炎性细胞因子的关系。方法选择南阳医学高等专科学校第一附属医院2023年1月-2024年6月收治的90例NRDS新生儿作为NRDS组;选择同期90例未患NRDS的新生儿作为对照组。对比两组新生儿血清Toll样受体4(toll like receptor 4,TLR4)和白介素-6(interleukin-6,IL-6)、肿瘤坏死因子-ɑ(tumor necrosis factor-ɑ,TNF-ɑ)、C-反应蛋白(C-reactive protein,CRP)和降钙素原(procalcitonin,PCT)水平;以logistic回归模型筛选上述指标中导致NRDS的危险因素;采用受试者工作特征曲线分析上述指标对NRDS诊断价值。结果NRDS组患儿血清中TLR4、IL-6、TNF-ɑ、CRP及PCT水平高于对照组,差异有统计学意义(P<0.05);IL-6、TNF-ɑ、CRP、PCT、TLR4是新生儿出现NRDS的危险因素(P<0.05);单独检测TLR4、IL-6、TNF-ɑ、CRP和PCT对NRDS的诊断具有一定应用价值,五项指标联合检测效能优于各指标单独检测。结论NRDS患儿血清中TLR4水平高表达,在一定程度上能够反映患儿病情的炎症程度,具有较好的诊断效能,而且联合常见炎性细胞因子诊断效能更佳。Objective To explore the diagnostic value of serum TLR4 in neonatal respiratory distress syndrome(NRDS)and its relationship with common inflammatory cytokines.Methods Ninety newborns with NRDS admitted to the First Affiliated Hospital of Nanyang Medical College from January 2023 to June 2024 were selected as the NRDS group.90 newborns who did not suffer from NRDS during the same period were selected as the control group.The levels of toll like receptor 4(TLR4)and inflammatory cytokines in the serum of two groups of newborns were compared.The risk factors for NRDS of above indicators were screened by logistic regression model.The diagnostic value of above indicators in NRDS was analyzed by the receiver operating characteristic curve.Results The levels of TLR4,interleukin-6(IL-6),tumor necrosis factor-ɑ(TNF-ɑ),C-reactive protein(CRP),and procalcitonin(PCT)in the serum of children with RDS were significantly higher than those in the control group(P<0.05).IL-6,TNF-α,CRP,PCT,and TLR4 are risk factors for neonatal NRDS(P<0.05).The individual detection of TLR4,IL-6,TNF-α,CRP and PCT has certain diagnostic value for NRDS,and the combined detection efficiency of the five indicators was better than the individual detection of each indicator.Conclusion The high expression of TLR4 in the serum of newborns with NRDS can reflect the degree of inflammation,and has good diagnostic efficacy.Moreover,the combination with common inflammatory cytokines has even better diagnostic efficacy.

关 键 词：新生儿呼吸窘迫综合征 TOLL样受体4 炎性因子 诊断 

分 类 号：R722[医药卫生—儿科]