外周血Toll样受体3在脓毒症患儿免疫治疗过程中的表达变化

Change of expression of Toll- like receptor 3 in peripheral blood of children with sepsis during immunotherapy

目的评估脓毒症患儿免疫治疗前后的外周血Toll样受体3(TLR3)表达水平变化。方法临床收治的45例脓毒症患儿在行常规治疗基础上,采用随机数字表法分为小剂量糖皮质激素治疗组(GC组)、静脉丙种球蛋白治疗组(IVIG组)、小剂量糖皮质激素+静脉丙种球蛋白治疗组(GC+IVIG组)各15例,于免疫治疗前和免疫治疗后第二天分别抽取外周血应用流式细胞术检测单个核细胞TLR3表达。选择30例门诊健康体检儿童为对照组,使用同样的方法抽取外周血检测单个核细胞TLR3表达。结果脓毒症患儿外周血单个核细胞TLR3表达免疫治疗前为(32.16±8.56)%和治疗后为(14.82±3.94)%均较正常儿童(5.71±2.44)%升高,差异有统计学意义(P<0.01);脓毒症患儿经不同免疫方案治疗后外周血单个核细胞TLR3表达均比治疗前下降,差异有统计学意义(P<0.01)。结论外周血单个核细胞TLR3的表达水平可以预示机体的免疫状态。

Objective To evaluate the change of expression of Toll-like receptor 3 （TLR3） in peripheral blood of children with sepsis before and after immunotherapy. Methods Based on routine treatment, 45 children with sepsis were randomly divided into low-dose glu- cocorticoid treatment group （GC group）, intravenous gamma globulin treatment group （IVIG group）, low-dose glucocorticoid and intravenous gamma globulin treatment group （ GC＋IVIG group） according to random number table, 15 children in each group. Flow cytometry was used to detect TLR3 expression in mononuclear cells of peripheral blood before immunotherapy and on the next day of immunotherapy. Thirty healthy children after physical examination in Department of Outpatient were selected as control group, TLR3 expression was detected using the same method. Results The expressions of TLR3 in children with sepsis before and after immunotherapy were （32. 16±8.56 ）% and （ 14. 82±3.94） %, respectively, which were statistically significantly higher than that in normal children [ （5, 71±2.44） % ] （P〈0.01） . The expressions of TLR3 in children with sepsis after treated by different immunotherapy options were statistically significantly lower than that before immunotherapy （P〈0.01） . Conclusion The expression level of TLR3 in mononuelear cells of peripheral blood can indicate immune status.