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目的:观察感染性早产患者外周血单个核细胞Toll样受体4(TLR4)的表达变化,探讨其与感染性早产发生的关系以及在早期预测中的价值。方法:收集31例早产(28～36+6周)患者部分胎盘胎膜组织行病理检查,根据病检有无绒毛膜羊膜炎分为早产感染组(17例)和早产非感染组(14例),门诊进行孕检的同孕周正常孕妇作为正常对照组(10例)。①采用酶联免疫吸附法测定血清中的IL-6水平;②应用流式细胞术观察早产患者和正常对照组孕妇外周血CD14+单个核细胞上TLR4分子的表达率和平均荧光强度(MFI);③检测血常规。结果:①TLR4在早产感染组患者外周血CD14+单个核细胞的阳性率为(39.22±13.17)%,平均荧光强度为(48.45±11.66),显著高于早产非感染组和正常对照组(P<0.05);而TLR4分子在早产非感染组和正常对照组外周血CD14+单个核细胞的阳性率和MFI相比,差异无统计学意义(P>0.05);②早产感染组孕妇血清中IL-6水平为(2.56±0.36)pg/ml,明显高于早产非感染组孕妇和正常对照组孕妇,差异有统计学意义(P<0.05),但早产非感染组和正常对照组血清中IL-6水平比较,差异无统计学意义(P>0.05);③感染性早产患者外周血TLR4的MFI与血清中IL-6水平成正相关(r=0.727,P<0.05),与血常规中的白细胞总数和中性粒细胞百分比无明显相关性。结论:①感染性早产患者外周血单个核细胞表面TLR4及血清IL-6表达明显增强,提示TLR4的信号通路可能与感染性早产的发生发展密切相关;②TLR4平均荧光强度与血清中IL-6水平成正相关,可作为早期预测早产宫内感染的指标。
Objective: To observe the expression of Toll-like receptor 4 (TLR4) in peripheral blood mononuclear cells of premature infants who have been infected with infectious diseases and explore its relationship with the occurrence of infectious preterm birth and its value in early prediction. Methods: The placental fetal membranes of 31 preterm (28-36 + 6 weeks) patients were collected for histopathological examination. According to the pathological findings of chorioamnionitis, 17 cases of preterm labor and 14 cases of nonpregnant premature labor ), Outpatient pregnancy test with gestational weeks normal pregnant women as a normal control group (10 cases). ① The levels of IL-6 in serum were detected by enzyme-linked immunosorbent assay; ②The expression of TLR4 and the mean fluorescence intensity (MFI) of CD14 + mononuclear cells in preterm labor and normal controls were observed by flow cytometry; ③ test blood. Results: (1) The positive rate of CD14 + mononuclear cells in peripheral blood of TLR4 infection group was (39.22 ± 13.17)%, the average fluorescence intensity was (48.45 ± 11.66), significantly higher than that of non-infected preterm group and normal control group ). There was no significant difference in the positive rate of TLR4 between CD14 + mononuclear cells (PBMC) and MFI (P> 0.05) in non-infected and non-infected preterm infants; ②The level of IL-6 (2.56 ± 0.36) pg / ml, which was significantly higher than that of non-infected preterm pregnant women and normal pregnant women (P <0.05), but the level of IL-6 in preterm non-infected group and normal control group (P> 0.05); ③ The MFI of peripheral blood TLR4 in infective preterm labor was positively correlated with the level of IL-6 in serum (r = 0.727, P <0.05), but not with the total number of leukocytes No significant correlation with neutrophil percentage. Conclusions: ①The expression of TLR4 and IL-6 on peripheral blood mononuclear cells in infective preterm labor are significantly increased, suggesting TLR4 signaling pathway may be closely related to the occurrence and development of infective preterm labor; ②The mean fluorescence intensity of TLR4 is positively correlated with the level of IL-6 A positive correlation, can be used as an indicator of early prediction of intrauterine infection of preterm labor.