【摘要】 目的探讨外周血有核细胞CD14mRNA在急性脑血管病(ACVD)引发全身炎症反应综合征(SIRS)及多器官功能障碍综合征(MODS)发病过程中的表达规律以及与病情变化的相关性。方法将153例ACVD患者按病情发展分为单纯ACVD组60例、ACVD引发SIRS组45例及ACVD引发MODS组48例,随机选择无亲缘关系的健康体检者40例作为对照组,采用逆转录-聚合酶链反应(RT-PCR)测定4组对象外周血有核细胞CD14 mRNA的表达。结果 ACVD患者发病第3日CD14 mRNA表达明显升高,CD14mRNA的表达随着病情的逐步加重(对照组→单纯ACVD组→ACVD引发SIRS组→ACVD引发MODS组)呈递升趋势(P<0.01),且4组两两比较也均有统计学意义(P均<0.01)。ACVD引发MODS组中,积分≥9分患者CD14 mRNA的表达明显高于<9分患者(P<0.05),死亡患者外周血有核细胞CD14 mRNA的表达明显高于存活患者(P<0.01)。结论 ACVD这一外源性非感染疾病引发SIRS和MODS的机制可能与机体过度免疫应答有关。更多还原

【Abstract】 Objective To study CD14 mRNA express in karyocyte of peripheral blood in the course of systemic inflammatory response syndrome(SIRS)/multiple organ dysfunction syndrome(MODS) induced by acute cerebral vascular diseases(ACVD) and its relation with the change of patient’s condition.Method According to the developing of patient’s condition,153 patients with ACVD were divided into 3 groups:simple ACVD group(n=60),SIRS induced by ACVD group(n=45) and MODS induced by ACVD group(n=48).Forty healthy subjects without consanguinity were selected as control group.The CD14 mRNA express in karyocyte of peripheral blood was measured by reverse transcription polymerase chain reaction(RT-PCR) in all participants.Result At the third day of onset,the CD14 mRNA express increased significantly in patients with ACVD.With the exacerbation of patient’s condition(control group→simple ACVD group→SIRS induced by ACVD group→MODS induced by ACVD group),the CD14 mRNA express gradually increased in turn,and there was significant difference in the comparing of each two groups among 4 groups(all P<0.01).In MODS induced by ACVD group,the CD14 mRNA express in patients with score more than or equal to 9 was higher than that in patients with score less than 9(P<0.05),and the CD14 mRNA express in died patients was higher than that in survival patients(P<0.01).Conclusion The mechanism of inducing SIRS and MODS of ACVD,an exogenous non-infective disease,could be related to the excessive immunity response.更多还原