血清TLR4在COPD患者中的表达及其与肺功能、 mMRC分级及CAT评分的相关性研究

Study on Serum TLR4 Concentration of COPD Patients and Its Relevance with Lung Function, mMRC Classification and CAT Score

目的:探讨血清Toll样受体4(Toll-like receptor4,TLR4)在慢性阻塞性肺疾病(COPD)发病机制中的作用,并分析其与肺功能、改良英国医学研究委员会呼吸困难问卷(mMRC分级)及慢阻肺评估测试(CAT评分)的相关性。方法:选取2016年12月-2017年12月于我科就诊的吸烟COPD稳定期患者60例及同期于该院行健康体检的吸烟者45例、非吸烟者45例为研究对象,比较COPD稳定期患者与健康吸烟者、健康非吸烟者血清TLR4表达水平的差异,分析血清TLR4水平与COPD患者气流受限及症状评估指标第1秒用力呼气容积占预计值的百分比(FEV1%pred)、mMRC分级、CAT评分的相关性。结果:COPD组血清TLR4水平高于健康吸烟组及健康非吸烟组(P均<0.05);COPD组血清TLR4水平与FEV1%pred呈负相关(r=-0.623,P<0.05)。COPD组血清TLR4水平与mMRC分级呈正相关(r=0.326,P<0.05),与CAT评分呈正相关(r=0.589,P<0.05)。结论:血清TLR4参与了COPD的炎症免疫发病机制,且与患者气流受限严重程度、呼吸困难严重程度及健康损害程度具有相关性。

Objective:Investigate the effect of serum Toll-like receptor4(TLR4)on Chronic Obstructive Pulmonary Disease(COPD)patients and its relevance with lung function,modified british medical research council(mMRC)classification and COPD Assessment Test(CAT)score.Methods:During the period from December 2016 to December 2017,selected from our hospital 60 smokers with COPD at stable phase,45 healthy smokers and 45 healthy non-smokers as the research objects,to compare their serum TLR4 concentrations and analyze the relationship between COPD patients’serum TLR4 concentration with their degree of airway limitation and the three indicators-the first second forced expiratory volume accounted for the predicted percentage(FEV1%pred),mMRC classification,and CAT score.Results:The COPD patient group showed higher serum TLR4 concentration than the rest two groups(all P<0.05);the COPD patient group showed negative correlation in their serum TLR4 concentration and FEV1%pred(r=-0.623,P<0.05).The COPD patient group showed positive correlation in their serum TLR4 concentration with mMRC classification(r=0.326,P<0.05)and CAT score(r=0.589,P<0.05).Conclusion:The serum TLR4 influences the inflammatory immune pathogenesis,and its concentration is affected by the degree of airway limitation and dyspnea and physical state.