摘要
目的 观察严重脓毒症患者外周血单个核细胞（PBMC）TOLL样受体（TLR）4及下游炎症介质的表达变化，及持续性血液透析治疗对其的调控作用。方法 13例严重脓毒症患者设为治疗组，另设6例健康志愿者为对照组．采用RT-PCR的方法检测PBMC中TLR4的表达，用流式细胞仪检查PBMC表面TLR4的表达，用ELISA法检测血清中IL-6、TNF-α的浓度。结果 经过高容量血液滤过（HVHF）的CRRT治疗以及其他综合治疗后，好转患者的IL-6和TNF-α明显降低，临床症状趋向好转，同时TLR4的表达也有降低，但是其降低幅度滞后于IL-6和TNF-α的降低幅度。在好转期病人仍有高水平的TLR4的表达。结论 CRRT由于其对炎症因子的去除作用而在严重脓毒症的治疗中具有重要的意义，而且其在降低炎症因子的同时可以降低单核细胞表面TLR4的表达，这对患者的预后具有重要意义。
Objective To explore the change of toll-like receptor 4 of peripheral blood mononuclear cell（PBMC） and the expression of cytokines in patients with severe sepsis, investigate the control faction of the continuous renal replacement therapy（CRRT）. Methods A clinical study was performed on 13 severe sepsis patients. Another 6 healthy individuals served as control. The mRNA expression of TLR4 was detected by RT- PCR, the expression of IL-6 ,TNF-α was measured by ELISA, the protein expression of TLR4 on PBMC was investigated by flow cytometry. Results TLR4 mRNA, IL- 6, TNF-α, TLR4 protein expression were upregulated markedly in severe sepsis patients. The above indexes decreased significantly after CRRT. Conclusion CRRT have important value in the therapy of sever sepsis due to its removal function of eytokines, and most importantly, this therapy can down regulated the expression of TLR4 on monoeyte, and this point is significant to the prognosis of the patients.
出处
《世界急危重病医学杂志》
2007年第4期1925-1928,共4页
internationl journal of emergency and critical care medicine
基金
南京军区南京总医院科研发展基金（200652）
