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目的:研究核苷酸结合寡聚化结构域2(NOD2)—受体相互作用蛋白2(RIP2)—核因子-κB(NF-κB)信号通路在肺曲霉病患者肺泡灌洗液中的表达水平及其作用机制。方法:选取2016年1月至2018年12月福建省老年医院呼吸与危重症医学科收治的62例肺曲霉病患者，男34例，女28例，年龄(53.58±12.34)岁，年龄范围为41～68岁，根据2008年美国感染病学会曲霉病诊治临床实践指南的分级诊断标准中的组织病理、微生物结果、临床症状等资料，将患者分为侵袭性肺曲霉病(IPA)组(n n＝28)和非侵袭性肺曲霉病(NIPA)组(n n＝34)，并选取20例健康志愿者为健康组，男12例，女8例，年龄(50.23±6.59)岁，年龄范围为43～62岁。采用荧光定量——聚合酶链式反应(PCR)法检测NOD2 mRNA、RIP2 mRNA、NF-κB mRNA表达，采用Western blot法检测NOD2、RIP2、NF-κB蛋白表达，采用酶联免疫吸附测定(ELISA)检测肺泡灌洗液上清液超敏C反应蛋白(hs-CRP)与白细胞介素6(IL-6)表达水平，并探讨其相关性。n 结果:IPA组NOD2 mRNA(7.46±1.86)、RIP2 mRNA(11.21±4.01)、NF-κB mRNA(58.80±14.23)和NIPA组NOD2 mRNA(3.38±0.97)、RIP2 mRNA(7.87±0.94)、NF-κB mRNA(39.10±9.84)的表达水平均高于健康组[(1.28±0.42)、(1.43±0.23)、(12.10±4.36)]；IPA组NOD2(2.04±0.42)、RIP2(1.54±0.34)、NF-κB(1.33±0.31)和NIPA组NOD2(1.76±0.36)、RIP2(1.15±0.29)、NF-κB(1.03±0.31)蛋白的表达水平均高于健康组[(0.75±0.21)、(0.63±0.18)、(0.51±0.12)]；IPA组IL-6[(23.72±6.54)μg/L]、hs-CRP[(17.38±4.42)mg/L]和NIPA组IL-6[(18.62±5.35)μg/L]、hs-CRP[(9.64±3.01)mg/L]均高于健康组[(5.02±1.64)μg/L、(3.63±1.61)mg/L]，差异均有统计学意义(n P<0.05)。Spearman相关性分析显示，NOD2 mRNA与NF-κB mRNA呈正相关(n r＝0.483)；RIP2 mRNA与NOD2 mRNA呈正相关(n r＝0.655)；hs-CRP与NOD2 mRNA呈正相关(n r＝0.572)；NOD2 mRNA与IL-6呈正相关(n r＝0.347)，差异有统计学意义(n P<0.05)。n 结论:肺曲霉病患者支气管灌洗液中NOD2、RIP2、NF-κB mRNA和蛋白表达均升高，与hs-CRP、IL-6炎症指标呈正相关性，NOD2可能通过RIP2依赖的NF-κB信号通路介导肺曲霉病患者致炎过程。“,”Objective:To investigate the expression of nucleotide binding oligomeric domain 2(NOD2)-receptor interacting protein 2(RIP2)-nuclear factor-kappa B(NF-κB)in pulmonary lavage fluid of patients with pulmonary aspergillosis and its mechanism.Methods:A total of 62 patients with pulmonary aspergillosis admitted to the department of Respiratory and Critical Care Medicine of Fujian Geriatric Hospital from January 2016 to December 2018 were selected, including 34 males and 28 females, aged(53.58±12.34)years old, ranging from 41 to 68 years old.According to the 2008 clinical practice guidelines of diagnosis and treatment of the infectious diseases society of America aspergillosis of the diagnostic criteria of histopathologic grading, microbial results, clinical symptoms, such as data, divided the patients into invasive pulmonary aspergillosis(IPA)group(n n=28)and non-invasive pulmonary aspergillosis(NIPA)group(n n=34), and 20 cases of healthy volunteers for health group, male 12 cases, female 8 cases, aged(50.23±6.59)years old, ranging from 43 to 62 years old.The expression of NOD2 mRNA, RIP2 mRNA and NF-κB mRNA were detected by fluorescence quantitative analysis using polymerase chain reaction method, and NOD2, RIP2 and NFB protein were detected by Western blot, the expression of high-sensitivity C-reactive protein(hs-CRP) andinterleukin-6(IL-6) in supernatant of Alveolar lavage fluid was detected by enzyme-linked immunosorbent assay(Elisa), and the correlation between hs-CRP and IL-6 was investigated.n Results:The expression levels of NOD2 mRNA(7.46±1.86), RIP2 mRNA(11.21±4.01), NF-κB mRNA(58.80±14.23), and NOD2 mRNA(3.38±0.97), RIP2 mRNA(7.87±0.94), and NF-κB mRNA(39.10±9.84)in the IPA group were all higher than those in the healthy group[(1.28±0.42), (1.43±0.23), and(12.10±4.36)]. Levels of NOD2(2.04±0.42), RIP2(1.54±0.34), NF-κB(1.33±0.31), and NOD2(1.76±0.36), RIP2(1.15±0.29), and NF-κB(1.03±0.31)in the IPA group were all higher than those in the healthy group[(0.75±0.21), (0.63±0.18)and(0.51±0.12)]. The levels of IL-6[(23.72±6.54)μg/L], hs-CRP[(17.38±4.42)mg/L], and IL-6[(18.62±5.35)μg/L]and hs-CRP[(9.64±3.01)mg/L]in the NIPA group were significantly higher than those in the healthy group[(5.02±1.64)μg/L, (3.63±1.61)mg/L], and the differences were statistically significant(n P<0.05). Spearman correlation analysis showed that NOD2 mRNA was positively correlated with NF-κB mRNA(n r=0.483). RIP2 mRNA was positively correlated with NOD2 mRNA(n r=0.655); hs-CRP was positively correlated with NOD2 mRNA(n r=0.572). NOD2 mRNA was positively correlated with IL-6(n r=0.347), and the difference was statistically significant(n P<0.05).n Conclusion:The expression of NOD2, RIP2, NF-κB mRNA and protein in bronchial lavage fluid of pulmonary aspergillosis patients were increased, which were positively correlated with hs-CRP and IL-6 inflammatory indicators.NOD2 may mediate the inflammatory process of pulmonary aspergillosis patients through the RIP2-dependent NF-κB signaling pathway.