【摘要】 目的通过观察脓毒症患者Toll样受体-4(TLR-4)表达水平与降钙素原(PCT)、C-反应蛋白(CRP)对比研究,探讨其在脓毒症诊断、病情危重程度及预后的相关性。方法研究收录2010年9月至2011年9月入住我院内科ICU脓毒症患者20例(脓毒症组),单纯感染患者39例(非脓毒症组)。检测入住MICU第l、7天血清TLR-4、PCT、CRP的表达水平,TLR-4检测采用双抗体夹心ELISA法,CRP检测采用免疫散射比浊法,PCT检测采用电化学发光法。结果 (1)TLR-4水平第1天脓毒症组高于非脓毒症组、第7天脓毒症组高于非脓毒症组,PCT水平第1天脓毒症组高于非脓毒症组、第7天脓毒症组高于非脓毒症组,脓毒症组TLR-4、PCT水平第7天比第1天降低,P<0.05。(2)TLR-4水平第1天死亡组高于存活组,第7天死亡组高于存活组,PCT水平第1天死亡组高于存活组,第7天死亡组高于存活组,存活组TLR-4水平第7天比第1天降低,生存组及死亡组PCT、CPP的水平第7天比第1天降低,P<0.05。(3)描绘ROC曲线TLR-4敏感性93.5%,特异性82.1%,ROC曲线下面积0.701,PCT敏感性95%,特异性89.7%,ROC曲线下面积0.820,P<0.05。结论TLR-4、PCT可作为危重病人脓毒症辅助诊断的指标,以PCT敏感性、特异性最高,其次为TLR-4,CRP特异性、敏感性最差,PCT、CRP可作为评价脓毒症患者病情严重程度及预后的一项指标。更多还原

【Abstract】 Objective To observe the expression levels of Toll-like rece ptor4(TLR-4)in sepsis patients,compared with procalcitonin(PCT),C-reactive protein(CRP) levels,study their value in early diagnosis and prognosis of sepsis. Methods Included 20 sepsis patients(sepsis group),39 infection patients(non-sepsis group) from September 2010 to September 2011 in our hospital MICU.Test serum TLR-4,PCT,CRP expression on the first and seventh day.TLR-4 were detected by double antibody sandwich ELISA,CRP was detected by immune nephelometry,PCT detected by electro-chemiluminescence method. Results TLR-4 levels of sepsis group were higher than non-sepsis group on the 1st day,were higher on the 7th day.PCT levels of sepsis group were higher than non-sepsis group on the 1st day,were higher on the 7th day PCT,TLR-4 levels were decreased in sepsis group,P<0.05.TLR-4 levels of the death group were higher than survival group on the 1st day,were higher than survival group on the 7th day,PCT levels of the death group were higher than survival group on the 1st day,were higher than survival group on the 7th day,TLR-4 levels were decreased in survival sepsis group,CRP,PCT levels were both decreased in survival and death sepsis group,P<0.05.TLR-4 ROC curve depicting the sensitivity is 93.5%,specificity 82.1%,ROC area under the curve 0.701,PCT sensitivity is 95%,specificity 89.7%,ROC area under the curve 0.820,P<0.05. Conclusion The levels of TLR-4 and PCT can diagnosis sepsis,the sensitivity and specificity of PCT is best,PCT and CRP can reflect the severity and prognosis of sepsis.更多还原