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目的评估脓毒症患儿免疫治疗前后的外周血Toll样受体3(TLR3)表达水平变化。方法临床收治的45例脓毒症患儿在行常规治疗基础上,采用随机数字表法分为小剂量糖皮质激素治疗组(GC组)、静脉丙种球蛋白治疗组(IVIG组)、小剂量糖皮质激素+静脉丙种球蛋白治疗组(GC+IVIG组)各15例,于免疫治疗前和免疫治疗后第二天分别抽取外周血应用流式细胞术检测单个核细胞TLR3表达。选择30例门诊健康体检儿童为对照组,使用同样的方法抽取外周血检测单个核细胞TLR3表达。结果脓毒症患儿外周血单个核细胞TLR3表达免疫治疗前为(32.16±8.56)%和治疗后为(14.82±3.94)%均较正常儿童(5.71±2.44)%升高,差异有统计学意义(P<0.01);脓毒症患儿经不同免疫方案治疗后外周血单个核细胞TLR3表达均比治疗前下降,差异有统计学意义(P<0.01)。结论外周血单个核细胞TLR3的表达水平可以预示机体的免疫状态。
Objective To evaluate the changes of Toll like receptor 3 (TLR3) expression in peripheral blood of children with sepsis before and after immunotherapy. Methods 45 children with sepsis were randomly divided into low dose glucocorticoid treatment group (GC group), intravenous gamma globulin treatment group (IVIG group), low dose Corticosteroids + intravenous gamma globulin treatment group (GC + IVIG group) of 15 cases, before immunotherapy and the day after immunotherapy were extracted from peripheral blood mononuclear cells using flow cytometry TLR3 expression. Thirty healthy children were selected as the control group, and the same method was used to detect the expression of TLR3 in peripheral blood mononuclear cells. Results Compared with normal children (5.71 ± 2.44)%, TLR3 expression in peripheral blood mononuclear cells was (32.16 ± 8.56)% before treatment and (14.82 ± 3.94)% after treatment, the difference was statistically significant (P <0.01). The expression of TLR3 in peripheral blood mononuclear cells in children with sepsis was significantly lower than that before treatment (P <0.01). Conclusion The expression level of TLR3 in peripheral blood mononuclear cells can predict the immune status of the body.