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目的探讨急腹症全身炎症反应综合征(SIRS)患者外周血单个核细胞(PBMC)内Toll样受体(TLR)2、4基因表达变化及其意义。方法103例急腹症手术患者包括SIRS组65例,非SIRS组38例。采用逆转录聚合酶链反应(RT PCR)法检测TLR2、4mRNA的变化;酶联免疫吸附试验(ELISA)法检测TNF α和IL 6的表达;分析TLR2、4mRNA与TNF α和IL 6的表达量、住院时间和多器官功能障碍综合征(MODS)发生率之间的关系。结果入院第1天TLR4mRNA、TNF α和IL 6表达均升高至峰值,随后随病程下降,TLR2mRNA自入院起持续高表达至第5天,TLR2、4mRNA的表达与TNF α和IL 6、住院时间呈正相关,且TLR2、4mRNA表达越高,发生MODS的危险性越大。结论急腹症SIRS患者PBMC内TLR2、4基因表达显著增加,提示TLR在急腹症SIRS的发生发展过程中发挥了重要的促进作用。
Objective To investigate the changes of Toll-like receptor (TLR) 2,4 gene in peripheral blood mononuclear cells (PBMC) of patients with acute systemic inflammatory response syndrome (SIRS) and its significance. Methods A total of 103 patients with acute abdomen surgery included 65 patients in the SIRS group and 38 patients in the non-SIRS group. The changes of TLR2 and 4 mRNA were detected by reverse transcriptase-polymerase chain reaction (RT PCR). The expressions of TNFα and IL-6 were detected by enzyme-linked immunosorbent assay (ELISA). The expressions of TLR2, , Length of stay, and multiple organ dysfunction syndrome (MODS). Results The expression of TLR4mRNA, TNFα and IL-6 on the first day of admission increased to the peak value, then decreased with the course of disease. TLR2mRNA sustained high expression from admission to the fifth day, TLR2,4mRNA expression and TNFα and IL6, hospital stay Was positively correlated, and the higher the expression of TLR2,4 mRNA, the greater the risk of MODS. Conclusion The expression of TLR2,4 gene in peripheral blood mononuclear cells of patients with acute abdomen SIRS is significantly increased, suggesting that TLR plays an important role in the development of SIRS in acute abdomen.