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蛛网膜下腔出血患者TLR4/NF-κB信号通路变化及意义

Changes and Significance of TLR4/NF-κB Signaling Pathway in Patients with Subarachnoid Hemorrhage
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摘要 目的探究蛛网膜下腔出血患者Toll样受体4(Toll like receptor 4,TLR4)/核因子κB(nuclear factor kappa B,NF-κB)信号通路变化及意义。方法选取作者医院2018-05/2021-06月收治的60例蛛网膜下腔出血患者作为观察组,另选取同期体检健康者60例作为对照组。比较两组TLR4/NF-κB信号通路相关因子表达,分析蛛网膜下腔出血患者TLR4/NF-κB信号通路相关因子与神经功能损害美国国立卫生院卒中量表(national institutes of health stroke scale,NIHSS)评分的关系。比较不同预后患者发病第1、3、7、14天外周血TLR4/NF-κB信号通路相关因子,绘制受试者工作特征(receiver operating characteristic,ROC)曲线,评价TLR4/NF-κB信号通路相关因子对蛛网膜下腔出血患者预后的预测价值,分析TLR4/NF-κB信号通路相关因子与蛛网膜下腔出血患者预后不良风险的关系。结果观察组TLR4 mRNA、NF-κB mRNA表达均高于对照组,组间比较差异有统计学意义(P均<0.05)。蛛网膜下腔出血患者入院当天NIHSS评分为(11.24±3.12)分,根据Pearson相关性模型分析可知,蛛网膜下腔出血患者TLR4 mRNA、NF-κB mRNA表达均与NIHSS评分呈正相关关系(P<0.05)。不同组别间患者TLR4 mRNA、NF-κB mRNA相对表达量差异有统计学意义(F组间=8.037、19.348,P均<0.001),不同时间点患者TLR4 mRNA相对表达量差异有统计学意义(F时间=5.128、16.207,P均<0.001),且时间与组间存在交互效应(F交互=6.497、18.032,P=0.015、<0.001)。预后不良组患者发病第1天TLR4 mRNA、NF-κB mRNA相对表达量较预后良好组患者差异无统计学意义(P>0.05)。预后不良组患者发病第3天、7天、14天TLR4 mRNA、NF-κB mRNA相对表达量均高于预后良好组患者(P均<0.05)。预后不良组患者、预后良好组患者发病第3天TLR4 mRNA、NF-κB mRNA相对表达量升至最高(P均<0.05);发病第7天、14天TLR4 mRNA、NF-κB mRNA相对表达量均较发病第3天明显下降,且发病第14天降至最低(P� Objective To investigate the changes and significance of Toll like receptor 4(TLR4)/nuclear factor kappa B(NF-κB)signaling pathway in patients with subarachnoid hemorrhage.Methods A total of 60 patients with subarachnoid hemorrhage who were treated in author′s hospital from May 2018 to June 2021 were selected as the observation group,and 60 healthy people who underwent physical examination during the same period were selected as the control group.The expression of TLR4/NF-κB signaling pathway related factors between the two groups was compared,and the relationship between TLR4/NF-κB signaling pathway related factors and national institutes of health stroke scale(NIHSS)scores in patients with subarachnoid hemorrhage was analyzed.Factors related to TLR4/NF-κB signaling pathway in peripheral blood of patients with different prognosis at the 1st,3rd,7th and 14th days were compared;receiver operating characteristic(ROC)curve was drawn;the predictive value of TLR4/NF-κB signaling pathway related factors on the prognosis of patients with subarachnoid hemorrhage were evaluated,and the relationship between factors related to TLR4/NF-κB signaling pathway and the risk of poor prognosis in patients with subarachnoid hemorrhage were analyzed.Results The expressions of TLR4 mRNA and NF-κB mRNA in the observation group was higher than those in the control group,and the difference was statistically significant(all P<0.05).The NIHSS score of patients with subarachnoid hemorrhage was(11.24±3.12)on the day of admission,and the expression of TLR4 mRNA and NF-κB mRNA in patients with subarachnoid hemorrhage were positively correlated with the NIHSS score according to the Pearson correlation model(P<0.05).There were statistically significant differences in the relative expression levels of TLR4 mRNA and NF-κB mRNA among different groups(Finterblock=8.037,19.348,all P<0.001),the relative expression level of TLR4 mRNA in patients at different timing had statistical significance(Ftime=5.128,16.207,all P<0.001),and there was a
作者 祁恒旭 张芸 QI Hengxu;ZHANG Yun(Department of Neurointerventional and Neurocritical Care,Dalian Central Hospital,Dalian Liaoning 116033,China;不详)
出处 《联勤军事医学》 CAS 2023年第2期125-129,147,共6页 Military Medicine of Joint Logistics
关键词 蛛网膜下腔出血 早期脑损伤 免疫炎症反应 TLR4/NF-kB信号通路 预后 Subarachnoid hemorrhage Early brain injury Immune inflammatory response Toll like receptor 4/nuclear factor kappa B signaling pathway Prognosis
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