重症脓毒症患者外周血单核细胞TLR4和炎性因子的表达及临床意义

目的 观察重症脓毒症患者外周血单核细胞(PBMC)膜结合CD14(mCD14)、TLR4及炎性因子的表达及临床意义.方法 选取符合重症脓毒症患者35例和健康志愿者15例作为对照.在患者被诊断重症脓毒症的第1、3、5天测定其外周血单核细胞mCD14、TLR4的表达及血清肿瘤坏死因子(TNF-α)、白细胞介素-10(IL-...

The expression and clinical significance of TLR4 and inflammatory factors in peripheral blood mononuclear cell in patients with severe sepsis

Objective To investigate the expression and clinical significance of mCD14,TLR4 and inflammatory factors in peripheral blood mononuclear cell(PBMC) in patients with severe sepsis.Methods Thirty-five patients with severe sepsis and fifteen healthy volunteers(control group) were enrolled in the investigation,and the patients were subdivided into two groups according to their prognoses,survival group(n=25) and death group(n=10).The expression levels of mCD14,TLR4 in PBMC and TNF-α,IL-10 in serum were detected at 1,3,5days after they were diagnosed,the APACHE-Ⅱscoring and SOFA scoring at the first day were performed,and the patients’ prognoses were evaluated.Results There were no significant differences in the expression levels of mCD14,TLR4 in PBMC at 1,3 days between survival group and death group(P>0.05),with mCD14(2.62±1.70 vs 2.58±1.33),(3.21±1.78 vs 2.89±1.73),TLR4(10.15±9.70 vs 11.09±8.92),(14.86±12.56 vs 11.09±8.92)respectively,however,which were significantly increased at the 5th day in survival group,as compared with those in death group(5.12±2.03 vs 2.75±0.67),(28.86±18.68 vs 13.41±11.73)(P<0.05).While APACHE-Ⅱscoring and SOFA scoring were obviously decreased,but there were no significant differences in the levels of serum TNF-α and IL-10 at 1,3,5days between the two groups(P>0.05).Conclusion The expression of mCD14 on PBMC in patients with severe sepsis is closely related with the patients’ prognoses,but the dynamic change of serum levels of TNF-αand IL-10 can not reflect the variation of disease and patients’ prognoses.