ApoE、NF-κB及TLR-4对剖宫产术后产褥感染的早期诊断价值

Value of ApoE, NF-κB and TLR-4 in early diagnosis of postoperative puerperal infection in cesarean section puerpera

目的 探究载脂蛋白E(ApoE)、核因子κB(NF-κB)及Toll样受体4(TLR-4)对剖宫产术后产褥感染的早期诊断价值。方法 选取2016年6月-2021年6月于新疆医科大学第五附属医院行剖宫产术后发生产褥感染产妇50例为研究组,同期剖宫产术后未发生产褥感染产妇48名为对照组,采用免疫比浊法检测血清ApoE,荧光定量聚合酶链反应(PCR)检测外周血NF-κB和TLR-4 mRNA表达水平,酶联免疫吸附法(ELISA)检测血清白细胞介素(IL)-6、IL-8和γ-干扰素(IFN-γ)。结果 研究组ApoE、NF-κB mRNA和TLR-4 mRNA表达水平分别为(67.23±15.17)mg/L、(1.25±0.24)mRNA、(0.45±0.13)mRNA均高于对照组(P<0.05);研究组IL-6、IL-8和IFN-γ水平分别为(13.49±3.22)pg/ml、(14.75±3.50)pg/ml、(10.86±2.96)pg/L均高于对照组(P<0.05);产褥感染产妇外周血ApoE、NF-κB mRNA和TLR-4 mRNA与IL-6、IL-8和IFN-γ水平呈正相关(P<0.05);受试者工作特征(ROC)曲线结果显示,ApoE、NF-κB mRNA和TLR-4 mRNA表达水平诊断剖宫产术后产褥感染的曲线下面积(AUC)分别为0.737、0.721、0.708,联合检测AUC为0.899,敏感度为86.00%,特异度为89.58%。结论 联合检测外周血ApoE、NF-κB mRNA和TLR-4 mRNA水平,对剖宫产术后产褥感染的早期诊断具有重要的应用价值。

OBJECTIVE To explore the value of apolipoprotein E(ApoE), nuclear factor κB(NF-κB) and Toll-like receptor 4(TLR-4) in early diagnosis of postoperative puerperal infection in cesarean section puerpera. METHODS From Jun 2016 to Jun 2021, a total of 50 puerpera who underwent cesarean section in the Fifth Affiliated Hospital of Xinjiang Medical University and had postoperative puerperal infection were assigned as the study group, meanwhile, 48 cesareans section puerpera who did not have puerperal infection were chosen as the control group. The serum ApoE was detected by immunoturbidimetry, the expression levels of peripheral blood NF-κB and TLR-4 mRNA were detected by means of polymerase chain reaction(PCR), and the serum interleukin(IL)-6, IL-8 and interferon-γ(IFN-γ) were detected by enzyme-linked immunosorbent assay(ELISA). RESULTS The expression levels of ApoE, NF-κB mRNA and TLR-4 mRNA of the study group were respectively(67.23±15.17)mg/L,(1.25±0.24)mRNA and(0.45±0.13)mRNA, higher than those of the control group(P<0.05). The levels of IL-6, IL-8 and IFN-γ of the study group were respectively(13.49±3.22)pg/ml,(14.75±3.50)pg/ml and(10.86±2.96)pg/L, higher than those of the control group(P<0.05). The peripheral blood ApoE, NF-κB mRNA and TLR-4 mRNA of the puerpera with puerperal infection were positively correlated with the levels of IL-6, IL-8 and IFN-γ(P<0.05). Receiver operating characteristic(ROC) curve analysis showed that the areas under curves(AUC) of ApoE, NF-κB mRNA and TLR-4 mRNA were respectively 0.737, 0.721 and 0.708 in diagnosis of postoperative puerperal infection;the AUC of the joint detection of the three indexes was 0.899, with the sensitivity 86.00%, the specificity 89.58%. CONCLUSION The joint detection of peripheral blood ApoE, NF-κB mRNA and TLR-4 mRNA has significant value in early diagnosis of postoperative puerperal infection in the cesareans section puerpera.