TLR4在晚发型新生儿败血症中意义.docVIP

TLR4在晚发型新生儿败血症中意义 　　[摘要] 目的 探讨Toll样受体4（TLR4）对晚发型新生儿败血症诊断的临床意义。 方法 选取2011年8月～2014年11月我院收治的血培养阳性的新生儿38例作为败血症组，根据感染病原体将其分为革兰阳性菌感染组（G+组）23例，革兰阴性菌感染组（G-组）15例，另选取我院同期收治的无感染性疾病的新生儿20例作为对照组，采集各组患儿外周血，应用密度梯度离心法分离出外周血单个核细胞，采用RT-PCR法检测TLR4 mRNA表达水平，免疫投射比浊法检测血清CRP水平。比较组间各指标的差异，并分析两者的相关性。 结果 G+组与G-组TLR4 mRNA及CRP水平与对照组相比均明显升高（P0.05）；G-组TLR4 mRNA的表达明显高于G+组（P0.05）。TLR4与CRP呈正相关（r=0.749，P0.01）。 结论 TLR4可以作为诊断晚发型新生儿败血症的有效指标，尤其对于识别革兰阴性菌感染更有意义。 　　[关键词] Toll样受体4；C反应蛋白；新生儿；败血症 　　[中图分类号] R722.1 [文献标识码] A [文章编号] 1673-9701（2016）12-0011-03 　　Significance of TLR4 in the late-onset neonatal septicemia 　　ZHOU Qin1 ZHANG Qin1 ZHOU Suya2 　　1.Department of Pediatrics， Zhejiang Peoples Hospital， Hangzhou 310014， China； 2.Department of Neonatology， Hangzhou Childrens Hospital， Hangzhou 310006， China 　　[Abstract] Objective To investigate the clinical significance of toll-like receptor 4（TLR4） in the diagnosis of late-onset neonatal septicemia. Methods A total of 38 newborns with positive blood culture who were admitted from August 2011 to November 2014 were selected as the septicemia group. According to the infection pathogens， the newborns were divided into gram positive bacteria infection group （G+） with 23 cases， gram negative bacteria infection group （G-） with 15 cases and 20 newborns without infectious diseases from the same period of time were selected as the control group. The peripheral blood of the newborns was collected and peripheral blood mononuclear cells were isolated with the density gradient centrifugation. The expression level of TLR4 mRNA was detected with RT-PCR method and serum CRP level was detected with immunity transmission turbidity. Compare the differences of each index of the two groups and analyze the correlation of the two groups. Results G+ group and G- group both had significant higher TLR4 mRNA and CRP level compared with that of the control group（P0.05）； the TLR4 mRNA level of G- group was significantly higher than that of the G+ group （P0.05）. TLR4 and CRP had p