摘要
目的探讨外周血CD14^(+)单核细胞Toll样受体2(TLR2)表达在肝硬化并发感染患者的诊断价值。方法选择我院诊治的104例肝硬化患者为研究组,根据是否感染分为感染组和未感染组,选取同期健康体检者96例为对照组。检测所有研究对象的外周血CD14、TLR2的表达及降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)水平,分析外周血CD14、TLR2的表达与肝硬化患者并发感染的关系,根据预后将感染组患者分为预后良好组和预后不良组,分析外周血CD14、TLR2表达对预后的预测价值。结果感染组外周血CD14、TLR2、PCT和TNF-α水平均高于未感染组及对照组(P<0.05);外周血CD14、TLR2分别与PCT、TNF-α水平呈正相关(P<0.05);外周血CD14、TLR2表达联合诊断肝硬化感染的曲线下面积(AUC)、敏感度、特异度、准确度均高于单一诊断(P<0.05);预后良好组外周血CD14、TLR2表达水平低于预后不良组,且外周血CD14、TLR2表达联合对肝硬化感染患者预后预测的AUC、敏感度、特异度、准确度均高于单一诊断(P<0.05)。结论外周血CD14、TLR2表达水平对肝硬化并发感染患者具有较高的诊断以及预后预测价值,与机体炎症反应状态密切相关,可作为临床治疗预后评估指标。
Objective To investigate the diagnostic value of toll-like receptor 2(TLR2)expression in peripheral blood CD14^(+)mononuclear cells for patients with cirrhosis and infection.Methods A total of 104 cirrhosis patients treated in our hospital were retrospectively analyzed(study group).According to presence or absence of infection,they were divided into infection and non-infection subgroups.Another 96 healthy controls during the same period were enrolled as a control group.The expressions of peripheral blood CD14 and TLR2,and the levels of procalcitonin(PCT)and tumor necrosis factor-α(TNF-α)were detected.The relationship between the peripheral blood CD14,TLR2 and the infection in cirrhosis patients was analyzed.According to different prognosis,patients with cirrhosis and infection were divided into good prognosis and poor prognosis subgroups.The predictive value of CD14 and TLR2 for prognosis was analyzed.Results The levels of peripheral blood CD14,TLR2,PCT and TNF-αin the infection subgroup were significantly higher than those in the non-infection subgroup and the control group(P<0.05).The peripheral blood CD14 and TLR2 were positively correlated with the levels of PCT and TNF-α(P<0.05).The area under the ROC curve(AUC),sensitivity,specificity and accuracy of CD14 combined with TLR2 in the diagnosis of cirrhosis and infection were significantly higher than those of single diagnosis(P<0.05).The expression levels of peripheral blood CD14 and TLR2 in the good prognosis group were significantly lower than those in the poor prognosis subgroup.AUC,sensitivity,specificity and accuracy of CD14 combined with TLR2 in predicting prognosis of patients with cirrhosis and infection were significantly higher than those of single diagnosis(P<0.05).Conclusion The expression levels of peripheral blood CD14 and TLR2 are high diagnostic and prognostic prediction value to patients with cirrhosis complicated by infection.They are closely related to inflammatory response status.Thus,they can be applied as the indexes of clinical treatment and prognostic evaluation.
作者
范潇月
刘飞飞
陈琳琳
FAN Xiao-yue;LIU Fei-fei;CHEN Lin-lin(Deyang People's Hospital,Deyang 618000,China)
出处
《实用医院临床杂志》
2021年第5期104-107,共4页
Practical Journal of Clinical Medicine
