2型糖尿病患者肺部感染TLR2/TLR4炎症信号通路及其危险因素

TLR2/TLR4 inflammatory signaling pathway of pulmonary infection in patients with type 2 diabetes mellitus and its risk factors

目的探究2型糖尿病患者肺部感染Toll样受体(TLR)2/TLR4炎症信号通路及其危险因素.方法回顾性分析2021年1月—2023年1月四川省人民医院收治的168例2型糖尿病患者的临床资料,根据2型糖尿病患者肺部感染情况分为感染组(n=33)和非感染组(n=135);统计2型糖尿病患者肺部感染病原菌,归纳2型糖尿病患者肺部感染的危险因素,比较两组外周血单个核细胞(PBMC)中TLR2、TLR4表达情况.结果33例2型糖尿病肺部感染患者共培养分离病原菌48株,其中革兰阴性菌29株占60.42%,革兰阳性菌14株占29.17%,真菌5株占10.42%,以大肠埃希菌、肺炎克雷伯菌为主;2型糖尿病病程、肺部并发症、住院时间是2型糖尿病患者肺部感染的危险因素(P<0.05);非感染组PBMC中TLR2 mRNA、TLR4 mRNA水平均低于感染组(P<0.001).结论2型糖尿病患者肺部感染病原菌以革兰阴性菌为主;2型糖尿病病程、肺部并发症、住院时间是2型糖尿病患者肺部感染的危险因素;2型糖尿病患者肺部感染PBMC中TLR2、TLR4呈高表达,临床可据此予以早期针对性防治而降低2型糖尿病患者肺部感染的发生风险.

OBJECTIVE To explore the Toll-like receptor(TLR)2/TLR4 inflammatory signaling pathway of pul-monary infection and its risk factors in patients with type 2 diabetes mellitus.METHODS The clinical data of 168 patients with type 2 diabetes admitted to Sichuan People's Hospital from Jan.2021 to Jan.2023 were retrospec-tively analyzed,and they were divided into the infected group(n=33)and the non-infected group(n=135)ac-cording to the pulmonary infection of patients with type 2 diabetes mellitus.The pathogenic bacteria of pulmonary infection in patients with type 2 diabetes mellitus were counted,the risk factors of pulmonary infection in patients with type 2 diabetes mellitus were summarized,and the expression of TLR2 and TLR4 in peripheral blood mono-nuclear cells(PBMC)of the two groups were compared.RESULTS A total of 48 strains of pathogenic bacteria were co-cultured and isolated from 33 patients with type 2 diabetes mellitus and lung infections,of which 29 strains of gram-negative bacteria accounted for 60.42%,14 strains of gram-positive bacteria accounted for 29.17%and 5 strains of fungi accounted for 10.42%,with Escherichia coli and Klebsiella pneumoniae being the main pathogens.The duration of disease,pulmonary complications and time of hospitalization were the risk fac-tors of pulmonary infection in patients with type 2 diabetes mellitus(P<0.05).The levels of TLR2 mRNA and TLR4 mRNA in PBMC in non-infected group were lower than those in infected group(P<0.001).CONCLUSION The main pathogenic bacteria of pulmonary infection in type 2 diabetes mellitus were gram-negative bacteria.The duration of disease,pulmonary complications and time of hospitalization were the risk factors of pul-monary infection in type 2 diabetes patients.TLR2 and TLR4 were highly expressed in PBMC of type 2 diabetes mellitus patients with pulmonary infection,which could be used for early targeted prevention and treatment to re-duce the risk of pulmonary infection in patients with type 2 diabetes mellitus.