TLR-2和TLR-4在不同疾病胸腔积液中的水平及临床意义

目的探讨不同疾病胸腔积液中Toll样受体2（TLR-2）及Toll样受体4（TLR4）的水平及其临床意义。方法收集81例胸腔积液及其同源外周血，其中结核性胸腔积液组32例，肿瘤性胸腔积液组28例，细菌性胸腔积液组21例。应用酶联免疫吸附（ELISA）法测定胸水上清液和血清中TLR-2和TLR-4的浓度，并对结果及意义进行分析。结果（1）胸腔积液间：结核组TLR-2浓度（22．19±2．12）ng／L分别与肿瘤性组（14．50±1．93）ng／L、细菌组（13．99±2．36）ng／L相比差异均有统计学意义（P〈0．05）；肿瘤性组、细菌组间相比差异均无统计学意义（P〉0．05）。而TLR4在三组间比较差异均无统计学意义（P〉0．05）。（2）血清中：细菌组TLR-4浓度（5．34±2．13）ng／L，分别与结核组（1．54±1．09）ng/L、肿瘤性组（0．10±0．06）ng／L相比差异均有统计学意义（P〈0．05）。（3）胸腔积液与血清中：TLR-2和TLR-4比较差异均有统计学意义（P〈0．05）。（4）结核性胸腔积液中：TLR-2和TLR-4具有相关性（P〈0．05）。结论TLR-2可有助于结核性与非结核性胸腔积液的鉴别。TLR-2和TLR-4在结核性胸膜炎发病中可能具有共同作用。

The level and meaning of Toll-like receptor 2 and 4 in pleural effusion with various etiologies

Objective To investigate the concentrations and clinical significance of Toll-like receptor 2 and 4 in pleural effusions with various etiologies. Methods Pleural effusion samples were obtained from 81 patients who presented to the respiratory institute （32 with tuberculous pleural effusion ,28 with malignant pleural effusion and 21 with bacterial pleural effusion）. The pleural effusion and serum levels of TLR-2 and TLR-4 were determined by sand- wich enzyme- linked immunosorbent assays （ELISA）. Results （ 1 ） The concentrations of TLR-2 in tuberculous pleu- ral effusion （22. 19 ~ 2. 12 ）ng/L was higher than that in malignant group （14.50 ~ 1.93）ng,/L, in bacterial group （ 13. 99 ~ 2. 36 ）ng/L （P 〈 0. 05 ）. But there were no statistical significance between the malignant group and bacteri- al group （ P 〉 0.05 ）. （ 2 ） In serum, The concentrations of TLR-4 in bacterial group （5.34 ~ 2. 13 ） ng/L was higher than that in malignant group （0. 10 ~ 0. 06 ） ng/L, in tuberculous group （ 1.54 ＋_ 1.09 ） ng/L （ P 〈 0. 05 ）. （ 3 ） Be- tween pleura1 effusion and serum, there were statistical significance in the three groups （P 〈 0. 05 ）. （4）The concen- trations of TLR-2 and TLR-4 in tuberculous pleural effusion were positively correlated （ P 〈 0. 05 ）. Conclusion Pleural TLR-2 may be helpful for the differential diagnosis of tuberculous pleural effusion and notuberculous pleural effusion. TLR-2 and TLR-4 maybe play an important role in the pathogenesis of tuberculous pleurisy.