6%羟乙基淀粉200/0.5对脓毒症患者血浆单核细胞Toll受体4 mRNA表达的影响

Effect of 6% hydroxyethyl starch( HES)200 /0. 5 on the expression of Toll-like receptor-4 mRNA on monocytes in patients with sepsis

目的观察6%羟乙基淀粉(HES)200/0.5对脓毒症患者血浆单核细胞Toll受体4表达的影响。方法 30例脓毒症患者随机分为HES组(n=15)和LRS组(n=15),HES组于1 h内按15 ml/kg输入HES,LRS组1 h内输入等量复方乳酸钠林格氏液(LRS)。分别于输注前(T0)、输完后1 h(T1)、输完后3 h(T2)、输完后5 h(T3)用RT-PCR法检测单核细胞TLR4mRNA表达,酶联免疫吸附法(ELISA)测定血浆肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)水平。结果与T0相比较,HES组T1、T2、T3时TLR4 mRNA及TNF-α、IL-6水平明显降低(P<0.01);而LRS组T0、T1、T2、T3时TLR4 mRNA及TNF-α、IL-6水平变化并不明显(P>0.05)。结论 6%HES 200/0.5可能通过下调脓毒症患者血浆单核细胞Toll受体4 mRNA的表达抑制过度炎症反应。

Objective To investigate the effect of 6% hydroxyethyl starch（ HES200 /0. 5） on the expression of Toll-like receptor- 4 mRNA in monocytes in patients with sepsis. Methods Thirty patients with sepsis were randomly assigned into HES group（ n = 15） and LRS group（n = 15）. The patients were administrated with 15 ml / kg HES within 1 h in HES group and the same amount of LRS in LRS group. Blood samples were collected before drug infusion（T0）、at 1 h（T1）,3 h（T2）and 5 h（T3） after drug infusion. The expression of TLR4 mRNA in monocytes was detected by RT-PCR and the plasma concentrations of TNF-α and IL-6 were measured by ELISA. Results Compared with T0,the expression of TLR4 in monocytes and the levels of TNF-α and IL-6 were decreased significantly at T1,T2and T3in HES group（P 〈 0. 01）,while the expression of TLR4 in monocytes and the levels of TNF-α and IL-6 were not significantly different at different time point in LRS group（P 〉 0. 05）. Conclusion The 6% HES 200 /0. 5 can inhibit the excessive inflammatory response by down-regulating the expression of TLR4 in monocytes in sepsis patients.