摘要
目的 研究细胞因子谱及Toll样受体（TLRs）在儿童细菌感染中的表达以及临床意义.方法 随机选取2014年12月至2016年6月患有全身炎症反应综合征（SIRS）的住院儿童60例,革兰阳性菌（G＋）和革兰阴性菌（G＋）感染患儿各30例,分别将其作为G＋、G＋组,选取健康体检儿童20例作为对照组,比较各组外周血中肿瘤坏死因子（TNF）-α、干扰素（IFN）-γ、白细胞介素（IL）-2、IL-4、IL-6和IL-10水平以及TLR2和TLR4的表达情况.结果 G＋组、G-组患儿的TNF-α、IFN-γ、IL-2、IL-6和IL-10水平明显高于对照组,且G＋组IFN-γ、IL-6、IL-10水平明显低于G-组,差异有统计学意义（P〈0.05）;G＋组TLR2与G＋组及对照组比较显著升高,差异有统计学意义（P〈0.05）, G＋组TLR4水平显著高于G＋组和对照组,差异有统计学意义（P〈0.05）.治疗后,SIRS患儿的TNF-α、IFN-γ、IL-2、IL-4、IL-6和IL-10水平较治疗前显著下降,差异有统计学意义[（5.42 ± 1.34） ng/L 比（9.13 ± 2.91）ng/L、（3.91 ± 1.26）ng/L 比（6.69 ± 2.13）ng/L、（2.42 ± 0.34）ng/L 比（3.28 ± 0.62）ng/L、（3.57 ± 0.69）ng/L比（4.55 ± 1.17）ng/L、（18.82 ± 3.32）ng/L比（253.32 ± 38.21） ng/L、（14.32 ± 2.57）ng/L比（45.27 ± 8.24）ng/L]（P〈0.01）.治疗后,患儿外周血单核细胞表面的TLR2和 TLR4水平较治疗前也显著下降（0.366 ± 0.015比1.084 ± 0.053、0.424 ± 0.029比0.824 ± 0.068）,差异有统计学意义（P〈0.01）.结论 细胞因子谱与TLRs参与了细菌感染的过程,联合检测对诊断儿童细菌感染、鉴别感染类型具有重要的意义,可以为临床提供参考.
Objective To explore the expression of cytokine and Toll- like receptors（TLRs） in children′s bacterial infection and its clinical significance. Methods Sixty children patients with systemic inflammatory response syndrome（SIRS）were enrolled in this study from December 2014 to June 2016.They were infected by Gram-positive bacteria（G＋）, Gram-negative bacteria（G＋）, and regarded as G＋group （30 cases） and G- group （30 cases）. In addition, 20 healthy subjects were selected as control group.The levels of tumor necrosis factor（TNF）-α, interferon（IFN）-γ, interleukin（IL）-2, IL-4, IL-6, IL-10 and TLR2, TLR4 in peripheral blood were compared.Results The levels of TNF-α,IFN-γ,IL-2, IL-6 and IL-10 in G＋group and G-group were significantly higher than those in the control group, and the levels of IFN-γ,IL-6,IL-10 in G＋group were significantly lower than those in G＋group（P〈0.05）. The level of TLR2 in G＋group was significantly higher than that in G＋group and control group（P〈0.05）.The level of TLR4 in G＋group was significantly higher than that in G＋group and control group（P〈0.05）. After treatment, the levels of TNF-α, IFN-γ, IL-2,IL-4, IL-6,IL-10,TLR2 and TLR4 in SIRS were significantly lower than those before treatment： （5.42 ± 1.34） ng/L vs. （9.13 ± 2.91） ng/L, （3.91 ± 1.26）ng/L vs.（6.69 ± 2.13）ng/L,（2.42 ± 0.34）ng/L vs.（3.28 ± 0.62）ng/L,（3.57 ± 0.69）ng/L vs.（4.55 ±1.17） ng/L, （18.82 ± 3.32） ng/L vs. （253.32 ± 38.21） ng/L, （14.32 ± 2.57） ng/L vs. （45.27 ± 8.24） ng/L, 0.366 ± 0.015 vs.1.084 ± 0.053, 0.424 ± 0.029 vs.0.824 ± 0.068,P〈0.01.Conclusions Cytokine spectroscopy and TLRs is involved in the process of bacterial infection. Combined detection has great significance in the diagnosis of bacterial infection and identification of infection in children and can provide reference for clinic.
出处
《中国医师进修杂志》
2017年第12期1069-1072,共4页
Chinese Journal of Postgraduates of Medicine
基金
浙江省嘉兴市科技局项目（2014AY21037）
关键词
细胞因子谱
TOLL样受体
细菌感染
Cytokine spectroscopy
Toll-like receptors
Bacterial infection
