| 王文召,李娜,刘一鸣.颅脑损伤病儿血清血凝素样氧化低密度脂蛋白受体、Toll 样受体4 表达水平及临床意义研究[J].安徽医药,2023,27(3):546-549. |
| 颅脑损伤病儿血清血凝素样氧化低密度脂蛋白受体、Toll 样受体4 表达水平及临床意义研究 |
| Expression levels and clinical significance of serum LOX-1 and TLR4 in children with craniocerebral injury |
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| DOI：10.3969/j.issn.1009-6469.2023.03.027 |
| 中文关键词: 颅脑损伤 血凝素样氧化低密度脂蛋白受体 Toll样受体4 儿童 |
| 英文关键词: Craniocerebral injury Lectin-like oxidized low-density lipoprotein receptor-1 Toll-like receptor-4 Children |
| 基金项目:南京医科大学科技发展基金-一般项目(NMUB2018095) |
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| 中文摘要: |
| 目的 检测颅脑损伤病儿血清血凝素样氧化低密度脂蛋白受体(LOX-1)、Toll样受体4(TLR4)表达水平，探讨二者与颅脑损伤病儿发病的关系。方法 选取2020年1—12月在南京市儿童医院就诊的颅脑损伤病儿82例作为研究对象；另选取同时期保健科体检的90例健康儿童作为对照组。颅脑损伤病人出院后6个月，根据治疗结果格拉斯哥预后量表(GOS)评定，分为预后不良组33例和预后良好组49例。采用酶联免疫吸附测定(ELISA)检测所有受试者病儿血清LOX-1、TLR4表达水平，经Pearson法分析颅脑损伤病儿血清LOX-1、TLR4的相关性，受试者操作特征曲线(ROC曲线)分析LOX-1、TLR4水平对颅脑损伤病儿预后不良的预测价值；logistic回归分析影响颅脑损伤病儿预后不良的有关因素。结果 与对照组［(3.13±0.97)μg/L、(0.52±0.11)μg/L］相比，颅脑损伤病儿血清LOX-1［(13.24±1.69)μg/L］、TLR4表达水平［(8.83±1.57)μg/L］升高(P<0.05)；预后不良病儿(功能受限、活动受限)血清LOX-1［(16.31±2.30)μg/L］、TLR4水平［(11.19±2.05)μg/L］较预后良好病儿高［(11.17±1.28)μg/L、(7.19±1.25)μg/L］(P<0.05)；经Pearson法分析颅脑损伤病儿预后不良血清LOX-1、TLR4水平呈正相关(P<0.05)；ROC曲线分析结果显示，LOX-1、TLR4的曲线下面积(AUC)及其95%置信区间(CI)分别为0.76(0.65，0.88)、0.75(0.64，0.87)，二者联合诊断颅脑损伤病儿预后不良的AUC为0.91(0.84，0.98)，与LOX-1、TLR4单独检测比较，二者联合诊断颅脑损伤病儿预后不良的AUC更高(Z=2.18、2.35，P=0.029、0.019)；多因素logistic回归分析结果表明血清LOX-1、TLR4是颅脑损伤预后结果发生的影响因素(P<0.05)。结论 颅脑损伤病儿血清LOX-1、TLR4表达水平异常升高，监测血清LOX-1、TLR4水平可能有助于判断病人病情程度以及预后情况。 |
| 英文摘要: |
| Objective To detect the expression levels of serum lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) and Toll-like receptor-4 (TLR4) in children with craniocerebral injury, and to explore the relationship between the two and the onset of cra?niocerebral injury in children.Methods Eighty-two children with craniocerebral injury who were treated in Nanjing Children's Hospi?tal from January 2020 to December 2020 were selected as the research objects; in addition, 90 children who received physical examina?tion in the Health Department during the same period were selected as the healthy control group. Six months after discharge from the hospital, patients with craniocerebral injury were assigned into two groups according to Glasgow Outcome Scale (GOS), poor prognosis group (n=33) and good prognosis group (n=49). Enzyme-linked immunosorbent assay (ELISA) was used to detect the expression levels of serum LOX-1 and TLR4 in all subjects. Pearson method was used to analyze the correlation between serum LOX-1 and TLR4 in chil?dren with craniocerebral injury. A receiver operating characteristic curve (ROC) was used to analyze the predictive value of LOX-1 and TLR4 levels on the poor prognosis of children with craniocerebral injury, and logistic regression was used to analyze the related factors affecting the poor prognosis.Results Compared with the control group , the expression levels of serum LOX-1 [(13.24±1.69) μg/L vs.(3.13±0.97) μg/L] and TLR4 [(8.83±1.57) μg/L vs. (0.52±0.11) μg/L] in children with craniocerebral injury increased (P<0.05); the lev?els of serum LOX-1 [(16.31±2.30) μg/L vs. (11.17±1.28) μg/L] and TLR4 [(11.19±2.05) μg/L vs. (7.19±1.25) μg/L] in children with poor prognosis (limited function and activity) were higher than those in children with good prognosis, (P<0.05). Pearson method analysis results showed that serum LOX-1 and TLR4 levels were positively correlated (P<0.05). ROC curve analysis results showed that the area under the curve (AUC) and 95% confidence interval (CI) of LO X-1 and TLR4 were 0.76 (0.65, 0.88) and 0.75 (0.64, 0.87), respectively,while the AUC of poor prognosis in children with craniocerebral injury for combined LOX-1 and TLR4 detection was 0.91 (0.84, 0.98).Compared with respective detection of LOX-1 and TLR4, the AUC of poor prognosis in children with craniocerebral injury for com?bined detection of LOX-1 and TLR4 was higher (Z=2.18, 2.35, P=0.029, 0.019). Multivariate logistic regression analysis showed that serum LOX-1 and TLR4 were the influencing factors for the prognosis of craniocerebral injury (P<0.05).Conclusions The expression levels of serum LOX-1 and TLR4 in children with crainocerebral injury are abnormally increased. Monitoring the levels of serum LOX-1 and TLR4 may be helpful to judge the patient's condition and prognosis. |
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