TLR2和TLR4在维持性血液透析合并肺部感染患者外周血中的表达及意义

Expression and significance of TLR2 and TLR4 in peripheral blood of maintenance hemodialysis patients with pulmonary infection

目的探究Toll样受体2(TLR2)和Toll样受体4(TLR4)在维持性血液透析合并肺部感染患者外周血中的表达及意义。方法选择2016年1月至2021年1月太仓市中医医院重症医学科收治的维持性血液透析患者60例为对象,根据患者是否合并肺部感染分为感染组(n=13)、未感染组(n=47),分析维持性血液透析患者合并肺部感染的危险因素,评估外周血TLR2和TLR4表达对维持性血液透析患者肺部感染的预测价值。结果感染组年龄≥60岁占比、外周血TLR2、TLR4表达水平较未感染组明显高,血红蛋白、红细胞体积较未感染组明显低,差异有统计学意义(χ^(2)=21.502、2.158、2.844、28.283、29.875,P<0.05)。二元Logistic回归分析提示年龄、血红蛋白、红细胞体积、外周血TLR2和TLR4表达是维持性血液透析患者合并肺部感染的高危因素(P<0.05)。外周血TLR2和TLR4表达是维持性血液透析患者合并肺部感染的高危因素(P<0.05)。外周血TLR2和TLR4联合检测预测维持性血液透析合并肺部感染的ROC曲线下面积(0.767)和特异度(81.1%)较两者单一检测的高(P<0.05)。结论维持性血液透析合并肺部感染患者外周血TLR2、TLR4表达水平明显增高,两者联合检测可有效预测肺部感染风险,可为肺部感染的有效防治提供新思路。

Objective To investigate the expression and significance of toll-like receptor 2(TLR2)and toll-like receptor 4(TLR4)in peripheral blood of maintenance hemodialysis patients with pulmonary infection.Methods A total of 60 maintenance hemodialysis patients admitted to the Department of Intensive Care Medicine,Taicang Hospital of Traditional Chinese Medicine from January 2016 to January 2021 were selected as subjects.Patients were divided into the infected group and the uninfected group according to the presence or absence of pulmonary infection.The risk factors for pulmonary infection in patients with maintenance hemodialysis were analyzed.The predictive value of the expression of TLR2 and TLR4 in peripheral blood for pulmonary infection in patients with maintenance hemodialysis was evaluated.Results Compared with the uninfected group,the proportion of age≥60 years old,the expression levels of TLR2 and TLR4 in peripheral blood were significantly higher in the infected group,and the hemoglobin and red blood cell volume were significantly lower than those in the uninfected group,and the difference was statistically significant(χ^(2)=21.502,2.158,2.844,28.283,29.875,P<0.05).Binary logistic regression analysis indicated that age,hemoglobin,mean corpuscular volume,and peripheral blood TLR2 and TLR4 were high-risk factors for pulmonary infection in patients with maintenance hemodialysis(P<0.05).The expression of TLR2 and TLR4 in peripheral blood is a high risk factor for pulmonary infection in maintenance hemodialysis patients(P<0.05).The area under the ROC curve(0.767)and specificity(81.1%)of the combined detection of peripheral blood TLR2 and TLR4 in predicting maintenance hemodialysis complicated with pulmonary infection were higher than those of the two single detections(P<0.05).Conclusion The expression levels of peripheral blood TLR2 and TLR4 are significantly elevated in maintenance hemodialysis patients with pulmonary infection.The combined detection of the two parameters can effectively predict the risk of pulmonary infection and provide new ideas for the effective prevention and treatment of pulmonary infection.