小剂量激素对脓毒症患儿外周血单个核细胞中TLR3表达量的影响及其与病情变化的相关性

摘要

Objective:To study the effect of small dose hormone on TLR3 expression in peripheral blood mononuclear cells of children with sepsis and its correlation with the change of the illness.Methods:Patients who were diagnosed with sepsis in Yan'an People's Hospital between June 2014 and September 2017 were chosen as the research subjects and randomly divided into two groups,hormone group received small-dose glucocorticoid combined with routine therapy and control group accepted routine therapy;the TLR3 mRNA expression levels in peripheral blood as well as the contents of inflammatory molecules and oxidative stress molecules in serum were measured before treatment as well as 3 days,5 days and 7 days after treatment.Re-sults:3 days,5 days and 7 days after treatment,TLR3 mRNA expression levels in peripheral blood as well as TNF-α,ICAM-1,sTREM1,Presepsin,HMGB1,ESM1,LPO and MDA contents in serum of both groups of children were lower than those before treatment whereas SOD and GSH-Px contents were higher than those before treatment,and TLR3 mRNA expression levels in peripheral blood as well as TNF-α,ICAM-1,sTREM1,Presepsin,HMGB1,ESM1,LPO and MDA contents in ser-um of hormone group were lower than those of control group whereas SOD and GSH-Px contents were higher than those of control group;the TLR3 mRNA expression of hormone group was positively correlated with TNF-α,ICAM-1,sTREM1,Pre-sepsin,HMGB1,ESM1,LPO and MDA contents,and negatively correlated with SOD and GSH-Px contents.Conclusion:Small-dose hormone can inhibit the expression of TLR3 in peripheral blood mononuclear cells of children with sepsis to inhibit the inflammatory response and oxidative stress response in the course of disease.%目的:研究小剂量激素对脓毒症患儿外周血单个核细胞中 T LR3表达量的影响及其与病情变化的相关性.方法:选择在本院诊断为脓毒症的患儿作为研究对象并随机分为两组,激素组接受小剂量糖皮质激素联合常规治疗、对照组接受常规治疗;治疗前及治疗后3、5、7天时,测定外周血中 T LR3的m RN A表达量及血清中炎症分子、氧化应激分子的含量.结果:治疗后3、5、7天时,两组外周血中TLR3的mRNA 表达量及血清中 TNF-α、ICAM-1、sTREM1、Presepsin、HMGB1、ESM1、LPO、MDA的含量均低于治疗前,SOD、GSH-Px的含量均高于治疗前且激素组患儿外周血中 TLR3的mRNA 表达量及血清中 TNF-α、ICAM-1、sTREM1、Presepsin、HMGB1、ESM1、LPO、MDA 的含量均低于对照组,SOD、GSH-Px 的含量均高于对照组;激素组患儿 TLR3的 mRNA 表达量与 TNF-α、ICAM-1、sTREM1、Presepsin、HMGB1、ESM1、LPO、MDA 的含量呈正相关,与 SOD、GSH-Px 呈负相关.结论:小剂量激素能够通过抑制脓毒症患儿外周血单个核细胞中 T LR3的表达来抑制病程中的炎症反应及氧化应激反应.