甲基强的松龙对慢性阻塞性肺疾病急性加重期患者血清Toll样受体2表达的影响及意义

Effects of methylprednisoione on toll like receptor-2 expression in patients with acute exacerbations of chronic obstructive pulmonary disease and clinical significance

目的探讨慢性阻塞性肺疾病急性加重期（acute exacerbations of chronic obstructive pulmonary disease, AECOPD）患者外周血清Toll样受体2（toll like receptor-2，TLR2）在甲基强的松龙（甲强龙）治疗前后水平变化及甲强龙在AECOPD治疗中的作用机制。方法采用酶联免疫吸附试验法对临床上AECOPD患者（84例）及健康对照组（84名）TLR2水平测定。结果健康对照组血清TLR2水平高于AECOPD组（P〈0．05）；AECOPD未治疗组血清TLR2水平与甲强龙40mg／qd组、q12h组、qSh组治疗后同一时间比较差异有统计学意义（P〈0．05）；各治疗组治疗第3、5、7天血清TLR2水平与治疗前比较差异有统计学意义（P值均d0．05）。结论AEc0PD患者外周血清TLR2呈低表达，并随着AECOPD的严重程度增加表达逐渐下降；甲强龙能上调TLR2表达，在甲强龙40mg／qd组上调血清TLR2水平较另外两组高。

Objective To investigate the effects of methylprednisolone on serum toll like receptor-2 （TLR2） level in patients with acute exacerbations of chronic obstructive pulmonary disease （AECOPD） and to discuss the clinical significance. Methods Blood samples in 84 patients with AECOPD were collected. 84 healthy volunteers were enrolled as controls. Serum TLR2 level was measured by ELISA. Results Serum TLR2 level in control group was higher than that in AECOPD group （ P %0.05）. On the same day peripheral blood TLR2 levels in treated group qd,q12h,q8h were different from untreated group （ P 〈0.05）. Compared with before treatment, blood TLR2 levels in treated group qd, ql2h, qSh on the 3rd,Sth,7th day after treatment were increased （all P〈0.05）. Conclusions The expression of peripheral blood TLR2 in the patients with AECOPD is lower, and gradually decreases with the severity of AECOPD. Methylprednisolone can raise TLR2 expression,and in qd group the effection is the best with a minimum dose.