高血压肾损害患者血Toll样受体4和肿瘤坏死因子α的变化

Correlation Between Toll-like Receptor 4,Tumor Necrosis Factor-α Changes and Hypertensive Renal Damage

背景高血压肾损害发病机制复杂,已有研究表明Toll样受体4(TLR4)及血清肿瘤坏死因子α(TNF-α)可能与高血压的发生及发展相关,但就二者与高血压肾损害的关系报道较少。目的探讨TLR4及TNF-α水平与高血压肾损害的关系。方法将原发性高血压患者103例根据其24h尿蛋白定量检测结果分为两组:单纯高血压组(60例)和肾损害组(43例)。用流式细胞仪检测其外周血单核细胞表面TLR4的表达,酶联免疫吸附法检测血清TNF-α的水平。同期选择45例健康体检者作为对照组。结果对照组、单纯高血压组、肾损害组TLR4表达的阳性率分别为(37.8±15.9)%、(45.9±14.0)%、(54.8±20.7)%;外周血清TNF-α水平分别为(68.0±17.7)、(166.9±48.2)、(220.3±74.3)μg/L,自对照组到单纯高血压组到肾损害组TLR4表达强度和TNF-α水平均依次升高;相关分析显示,TLR4和TNF-α水平与24h尿蛋白定量呈正相关。结论高血压肾损害患者外周血单核细胞TLR4表达及血清TNF-α水平均明显升高,二者与高血压肾损害的程度呈正相关,但因果关系不明。

Background The pathogenesis of hypertensisve renal damage is complicated. It has been shown that toll-like receptor 4 （TLR4） and tumor necrosis factor-α （TNF-α） may correlate to the correlated and development of essential hypertension,whereas,there is a paucity of information on the relationship between their changes and hypertensive renal damage. Objective To investigate the associasion between TLR4,TNF-α concentration and renal damage induced by essential hypertension. Methods According to the patients＇s 24 h urine protein test results,103 cases of patients with essential hypertension were divided into two groups：simple hypertension group （n=60） and hypertensive renal damage group （n=43）. The levels of TLR4 on peripheral blood mononuclear cell surface and TNF-α in serum were detected flow cytometry and ELISA assay respectively. 45 cases of healthy individuals served as normal control group during the same period. Results In normal control group,simple hypertension group and hypertensive renal damage group,the positive rate of TLR4 were （37.8±15.9）%,（45.9±14.0）% and （54.8±20.7）% respectively;and the TNF-α were （68.0±17.7）,（166.9±48.2） and （220.3±74.3）μg/L respectively. The concentration of TLR4 and TNF-α rised significantly in the order of normal control group,simple hypertension group and hypertensive renal damage in turn. TLR4 and TNF-α levels were positively related to the 24 h urine protein test results characterized by correlation analysis. Conclusion The TLR4 and the TNF-α were significantly increased in the hypertensive patients with renal damage,and they may be positively correlated with the degree of renal damage induced by essential hypertension,but the causal relationship was unknown.