肝硬化患者外周血内毒素与单核细胞TLRs的关系及临床意义

Relationship between endotoxin and monocyte TLRs of peripheral blood in patients with liver cirrhosis and the clinical significance

目的分析肝硬化患者外周血内毒素与单核细胞Toll样受体(Toll-like receptors,TLRs)的关系及临床意义。方法选取雅安市中医院消化科2015年10月到2018年2月收治的乙型肝炎后肝硬化患者95例为研究组,根据肝功能Child-Pugh分级再分为3个亚组:A级组35例,B级组40例,C级组20例。选择同期健康体检者42例为对照组。分别采用基质显色法、流式细胞术和逆转录-聚合酶链反应(reverse transcription-polymerase chain reaction,RT-PCR)分别检测外周血内毒素、单核细胞Toll样受体2(toll-like receptor 2,TLR2)、Toll样受体4(toll-like receptor 4,TLR4)和Toll样受体7(toll-like receptor 7,TLR7)及mRNA。结果研究组各亚组的内毒素明显增高(P<0.05),与A级组比,B和C级组的内毒素明显增高(P<0.05),与B级组比,C级组的内毒素明显增高(P<0.05),与对照组比,研究组各亚组的TLR2和TLR4水平及mRNA水平明显增高(P<0.05),TLR7及mRNA明显降低(P<0.05),与A级组比,B和C级组外周血单核细胞的TLR2和TLR4及mRNA明显增高(P<0.05),TLR7明显降低(P<0.05),与B级组比,C级组外周血单核细胞的TLR2和TLR4及mRNA明显增高(P<0.05),TLR7及mRNA明显降低(P<0.05),经Pearson相关性分析显示,内毒素与单个核细胞TLR2、TLR4和TLR7及mRNA分别呈正相关、正和负相关(P<0.05)。结论肝硬化患者外周血内毒素与外周血单核细胞TLR2、TLR4和TLR7及mRNA呈线性相关关系,TLRS对评估肝硬化病情具有参考意义。

Objective To analyze the relationship between peripheral blood endotoxin and monocyte toll-like receptors(TLRs)in patients with liver cirrhosis and its clinical significance.Methods All of 95 patients with post-hepatitis B cirrhosis admitted to T.C.M Hospital of Ya'an from October 2015 to February 2018 were enrolled into our study.According to the Child-Pugh classification of liver function,the patients were divided into 3 subgroups:35 cases in Child-Pugh grade A group,40 cases in Child-Pugh grade B group and 20 cases in Child-Pugh grade C group.42 healthy subjects at the same period were selected as the control group.The peripheral blood endotoxin and monocyte TLR2,TLR4 and TLR7 mRNA of all subjects were detected by the matrix chromogenic assay,flow cytometry and reverse transcription-polymerase chain reaction(RT-PCR)respectively.Result The endotoxin levels in 3 subgroups of the study group significantly increased(P<0.05).Compared with the grade A group,the endotoxin levels in the grade B and C groups significantly increased(P<0.05).Compared with the grade B group,the endotoxin in the grade C group significantly increased(P<0.05).Compared with the control group,the peripheral monocyte TLR2,TLR4,TLR2 mRNA significantly increased(P<0.05),TLR7 and mRNA significantly decreased in 3 subgroups of the study group(P<0.05).Compared with the grade A group,the levels of peripheral monocyte TLR2,TLR4,and mRNA significantly increased(P<0.05),and the peripheral monocyte TLR7 and TLR7 mRNA had significantly decreased in grade B and grade C groups(P<0.05).Compared with the grade B group,the peripheral monocyte TLR2,TLR4,TLR2 mRNA and TLR4 mRNA in the grade C group had significantly increased(P<0.05),the peripheral monocyteTLR7 and TLR7 mRNA had significantly decreased(P<0.05).Pearson correlation analysis showed that there was linear correlation between endotoxin and mononuclear cells TLR2,TLR4 and TLR7 and TLR2 mRNA,TLR4 mRNA and TLR7 mRNA(P<0.05).Conclusion There is a linear correlation between peripheral blood endotoxin and monocyte TLR2,TLR4 and TLR7 and TLR2 mRNA,TLR4 mRNA and TLR7 mRNA in patients with cirrhosis,which has reference significance for evaluating liver cirrhosis.