TLR4在中枢神经系统感染性脓毒症患者中的表达

TLR4 expression in patients with central nervous system infectious sepsis

目的 :探讨Toll样受体4(TLR4)在中枢神经系统感染性脓毒症患者中的表达及与白细胞介素-6(IL-6)、降钙素原(PCT)水平的相关性。方法选择2018年5月-2019年6月胜利油田中心医院重症医学科治疗中枢神经系统感染性脓毒症患者78例设为试验组,所有患者在常规治疗基础上联合血必净注射液治疗;选择同期健康体检者61名,设为对照组。两组均采用酶联免疫吸附试验测定两组IL-6水平;采用化学发光法测定两组PCT水平;采用流式细胞仪测定两组TLR4阳性表达率;采用Pearson相关性分析软件对中枢神经系统感染性脓毒症患者TLR4表达与IL-6、PCT水平进行相关性分析。结果试验组TLR4、IL-6及PCT水平均高于对照组(P<0.05);化脓性感染患者TLR4、IL-6及PCT水平均高于病毒性感染及结核性感染患者(P<0.05);病毒性感染患者TLR4、IL-6及PCT水平均高于结核性感染患者(P<0.05);试验组治疗后6个月死亡9例,死亡组TLR4、IL-6及PCT水平均高于存活组(P<0.05);中枢神经系统感染性脓毒症患者中TLR4表达阳性率与IL-6、PCT水平呈正相关性(r=0.794、0.713,P<0.001)。结论 TLR4在中枢神经系统感染性脓毒症患者中呈高表达,且与IL-6、PCT水平存在相关性,可指导患者治疗,改善患者预后。

OBJECTIVE To investigate the expression of Toll-like receptor 4(TLR4) in patients with central nervous system sepsis and its correlation with interleukin-6(IL-6) and procalcitonin(PCT) levels. METHODS From May 2018 to Jun. 2019, 78 patients with central nervous system sepsis in the Department of Critical Care Medicine, Shengli Oilfield Central Hospital were recruited as the experimental group. All patients were injected with Xuebijing on the basis of conventional treatment. Sixty-one volunteers who had physical examination during the same period were enrolled as the control group. enzyme-linked immunosorbent assay were used in both groups to determine the levels of IL-6;chemiluminescence was used to detect the level of PCT in the two groups;flow cytometry assay was used to detect the positive expression rate of TLR4 in the two groups. The Pearson correlation analysis was used to analyze the correlation between TLR4 expression and IL-6 and PCT levels in patients with central nervous system sepsis. RESULTS The levels of TLR4, IL-6 and PCT in the test group were significantly higher than that in the control group(P<0.05);the levels of TLR4, IL-6 and PCT in patients with purulent infection were significantly higher than that with viral infection and tuberculosis(P<0.05);TLR4, IL-6 and PCT levels in patients with viral infection were significantly higher than that in patients with tuberculosis infection(P<0.05). Nine patients died in the experimental group 6 months after the treatment, and the TLR4, IL-6 and PCT levels in the death group were significantly higher than that in the survival group(P<0.05). The positive rate of TLR4 expression in patients with central nervous system sepsis was positively correlated with IL-6 and PCT levels(r=0.794, 0.713, P<0.001). CONCLUSION TLR4 is highly expressed in patients with sepsis of the central nervous system and is correlated with IL-6 and PCT levels, which can guide patients’ treatment and improve their prognosis.