病毒性反复呼吸道感染患者Toll样受体、D-二聚体及分泌型免疫球蛋白A/白蛋白的表达及预后意义

Expression of Toll-like receptor,D-dimer and sIgA/ALB in patients with repeated viral respiratory infec-tions and their relationship with severity of disease and prognosis

目的探讨Toll样受体(TLR)、血浆D-二聚体及分泌型免疫球蛋白A(sIgA)/白蛋白(ALB)在病毒性反复呼吸道感染(RRTIs)患者中的表达及与病情严重程度、预后的关系。方法选取75例病毒性RRTIs患者作为病例组,根据病情严重程度将其分为轻、中、重3组,分别25例、30例、20例,另选30例健康人群作为对照组。比较病例组和对照组及轻、中、重3组患者外周血TLR2、TLR9、血浆D-二聚体及唾液中sIgA/ALB表达情况,根据病例组患者预后情况分为预后良好组和预后不良组,比较这两组患者上述指标表达情况。结果病例组患者外周血TLR2、TLR9及血浆D-二聚体水平均明显高于对照组,唾液中sIgA/ALB表达水平明显低于对照组(P<0.001)。轻、中、重3组患者外周血TLR2、TLR9及血浆D-二聚体水平均呈逐渐升高趋势,唾液中sIgA/ALB表达水平呈逐渐降低趋势(P<0.001)。预后良好组患者外周血TLR2、TLR9及血浆D-二聚体水平均明显低于预后不良组,唾液中sIgA/ALB表达水平明显高于预后不良组(P<0.01)。结论病毒性RRTIs患者血浆D-二聚体水平升高,黏膜免疫功能下降,临床可根据上述指标表达情况预测患者病情严重程度及预后。

Objective To explore the expression of Toll-like receptor(TLR),D-dimer(D-D)and secreted immunoglobulin A(sIgA)/albumin(ALB)in patients with viral repeated respiratory infections(RRTIs),and analyze the relationship with severity of disease and prognosis.Methods A total of 75 patients with viral RRTIs were selected as the test group,and they were divided into 3 groups(mild group,n=25;moderate group,n=30 and severe group,n=20)according to the severity of the disease.Another 30 healthy people were selected as the control group.The peripheral blood TLR2,TLR9 expression levels,plasma D-D levels,sIgA/ALB expression in saliva were compared between the two groups.The patients were further divided into the good prognosis group and poor prognosis group,the expression of the above indicators in the two groups were compared.Results The expression of TLR2,TLR9 in the peripheral blood and plasma D-D levels of the test group were significantly higher than those of the control group,and the sIgA/ALB expression level in saliva was significantly lower than that of the control group(P<0.001).The expression of TLR2,TLR9 in the peripheral blood and plasma D-D levels showed a gradual increase trend,the sIgA/ALB expression level in saliva showed a gradual decrease trend in the mild group,moderate group and severe group(P<0.001).The expression of TLR2,TLR9 in the peripheral blood and plasma D-D levels of the good prognosis group were significantly lower than those in the poor prognosis group,and the sIgA/ALB expression level in saliva was significantly higher than that in the poor prognosis group(P<0.01).Conclusions Patients with viral RRTIs have elevated plasma D-D levels and decreased mucosal immune function,the clinical severity and prognosis of patients could be predicted based on the expression of the above indicators.