目的 研究Toll样受体(TLRs)信号通路和炎症因子的表达与反复呼吸道感染的关系,为临床治疗提供监测靶点。方法 将汕头市龙湖区第二人民医院儿科2019年1-12月门诊收治的150例反复呼吸道感染患儿纳入研究,记作病例组,另取同期于本院进行体检的健康儿童150例作为对照组。比较病变组和对照组儿童TLRs信号通路和炎症相关因子水平,并作相关性分析。此外,对比病变组和对照组儿童氧化应激反应相关指标水平。结果 病例组患儿Toll样受体2(TLR2)及TLR4水平显著高于对照组,差异有统计学意义(t=69.981,101.427,P＜0.001)。病例组患儿血清白细胞介素-4(IL-4)、白细胞介素-10(IL-10)及肿瘤坏死因子-α(TNF-α)水平显著高于对照组(t=78.453,63.388,116.697,P<0.001),干扰素γ(INF-γ)显著低于对照组(t=70.489,P<0.001)。Pearson相关性分析显示:反复呼吸道感染患儿TLR2、TLR4和血清IL-4、IL-10、TNF-α水平均呈正相关(P<0.05或<0.01),与INF-γ水平呈负相关(P<0.001)。病变组超氧化物歧化酶(SOD)、丙二醛(MDA)及过氧化氢酶(CAT)水平与对照组相比,差异均有统计学意义(t=28.633,57.277,50.103,P＜0.001)。结论 TLRs信号通路和炎症因子均可能参与反复呼吸道感染的发生、发展过程,且反复呼吸道感染患者存在明显的氧化应激状态异常。
Abstract
Objective To study the relationship between Toll like receptor (TLRs) signaling pathway and expression of inflammatory factors and recurrent respiratory tract infection, in order to provide monitoring targets for clinical treatment. Methods A total of 150 children with recurrent respiratory tract infection treated in the Second People's Hospital of Longhu District from January to December 2019 were included in this study and were selected as case group. Meanwhile, 150 healthy children who took physical examination were selected as control group. Then the levels of TLRs signaling pathway, inflammatory related factors and oxidative stress related indexes were compared between the two groups. Results The levels of Toll like receptor 2 (TLR2) and TLR4 in the case group were significantly higher than those in the control group(t=69.981, 101.427, P＜0.001). Additionally, the levels of serum interleukin-4 (IL-4),interleukin-10(IL-10) and interferon gamma (INF-γ) in the case group were significantly higher than those in control group(t=78.453, 63.388, 116.697, P＜0.001), while the level of tumor necrosis factor-α (TNF-α) was significantly lower in the case group(t=70.489, P＜0.001). Pearson correlation analysis showed that the TLR2 and TLR4 levels were positively related to the levels of IL-4, IL-10 and TNF-α, but negatively correlated with INF-γ levels(P＜0.05). The differences on superoxide dismutase(SOD), malondialdehyde(MDA) and catalase(CAT) between the case group and control group were significant(t=28.633, 57.277, 50.103, P＜0.001). Conclusion The TLRs signaling pathway and inflammatory factors may be involved in the occurrence and development of recurrent respiratory tract infection, and children with recurrent respiratory tract infection apparently have abnormal oxidative stress.
关键词
反复呼吸道感染 /
Toll样受体信号通路 /
炎症因子 /
氧化应激反应
Key words
recurrent respiratory tract infection /
Toll like receptor signaling pathway /
inflammatory factors /
oxidative stress response
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参考文献
[1] Marwah V, Singh S, Sethi N,et al.Retained tracheostomy tube brush tip manifesting as recurrentrespiratory tract infection[J].J Anaesthesiol Clin Pharmacol,2020,36(1):128-130.
[2] Manti S,Parisi GF, Papale M,et al.Bacteriotherapy with Streptococcus salivarius 24SMB and Streptococcus oralis 89a nasal spray for treatment of upper respiratory tract infectionsin children:a pilot study on short-term efficacy[J].Ital J Pediatr,2020,46(1):42-43.
[3] 张金凤,王雅歆,姚俊彦,等.维生素A、D、E对0～3岁反复呼吸道感染患儿治疗效果的影响和社区卫生服务干预措施分析[J].检验医学与临床,2020,17(7):910-913.
[4] 代晓茹,张茹,于玉兰,等.糖尿病足感染患者炎症因子和Toll样受体信号通路的表达及意义[J].中华医院感染学杂志,2020,30(2):198-202.
[5] 秦新华,王芳,赵保玲,等.重组人干扰素对手足口病大鼠的治疗作用及对Toll样受体/髓样分化因子相关信号分子的影响[J].新乡医学院学报,2020,37(1):15-20.
[6] 于涛,祝杨.急性加重期慢性阻塞性肺疾病患者感染呼吸道病毒特征及与炎性细胞因子关联分析[J].中国医师进修杂志,2019,42(9):786-790.
[7] 钱铃,章雷花,杨华飞,等.维生素A、E辅助药物治疗儿童反复呼吸道感染的疗效及免疫状态分析[J].中国妇幼保健,2020,35(1):50-53.
[8] Zhao N, Liu C, ZhuC,et al.Pidotimod:a review of its pharmacological features and clinical effectiveness in respiratory tract infections[J].Expert Rev Anti Infect Ther,2019,17(10):803-818.
[9] Mazina NK, Mazin PV, Khafisianova RK.Cycloferon efficacy in treatment of upper respiratory tract infections:systematic review and meta-analysis[J].Vestn Otorinolaringol,2019,84(3):82-88.
[10] Esposito S,Bianchini S, Bosis S,et al.A randomized, placebo-controlled, double-blinded, single-centre, phase IV trial to assess the efficacy and safety of OM-85 in children suffering from recurrent respiratory tract infections[J].J Transl Med,2019,17(1):284-286.
[11] 张琪,邓芳,毕良学,等.血清25-羟维生素D水平与儿童免疫功能和反复呼吸道感染的关联性分析[J].中国全科医学,2020,23(9):1112-1116.
[12] 张琳,何德根,陈慧,等.儿童反复呼吸道感染外周血 Th17细胞、唾液中分泌型免疫球蛋白 A／白蛋白比值变化及其意义[J].中国中西医结合儿科学,2016,8(4):387-389.
[13] 周倩倩,张宏贤,郭璠,等.“当归复感汤”治疗儿童反复呼吸道感染瘀热内结证69例临床研究[J].江苏中医药,2020,52(1):46-49.
[14] 傅发展,吕笑俏,柳俊瑾,等.匹多莫德和脾氨肽对呼吸道反复感染儿童外周血T细胞亚群及其细胞因子的影响[J].中华医院感染学杂志,2017,27(1):201-204.
[15] 刘小雪,谢婉新,于冬艺,等.15脂氧酶在反复呼吸道感染免疫炎症中的作用研究进展[J].国际免疫学杂志,2018,41(2):209-212.
[16] 向垣诚.急性上呼吸道感染严重程度与患者鼻腔灌洗液中白介素-8和嗜中性粒细胞含量的相关性分析[J].医学临床研究,2019,36(8):1460-1461.
[17] 楼英萍,傅兰兰,吴蓉洲,等.匹多莫德联合维生素D治疗反复呼吸道感染对TLRs信号通路和炎性因子的影响[J].中华医院感染学杂志,2019,29(15):2270-2274.
[18] 李天萍,黄霞飞,杨蕉,等.呼吸道合胞病毒感染性肺炎患儿的TNF-α 和IL-1β水平及TLR4信号通路作用初步探究[J].中华医院感染学杂志,2020,30(6):919-922.
[19] 李明,唐其柱.细胞因子与趋化因子的实验室检测在呼吸道感染患者中的意义探讨[J].检验医学与临床,2019,16(10):1428-1430.
[20] 方彩文,邹旭凤,徐小娟,等.学龄前儿童反复呼吸道感染危险因素及与维生素D相关性分析[J].中国儿童保健杂志,2019,27(6):673-676.
[21] 李云鹏.维生素A和E缺乏与儿童反复呼吸道感染发生的相关性[J].贵州医科大学学报,2020,45(3):331-334.
[22] 刘雪杰,付荣,陈秋芳,等.反复呼吸道感染患儿氧化应激状态变化研究[J].中华医院感染学杂志,2016,26(7):1637-1638.
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