杜琎,石开虎,胡定辉,李航,刘尊涛,王炜
DU Jin,SHI Kaihu,HU Dinghui,LI Hang,LIU Zuntao,WANG Wei

• 1:南京中医药大学附属中西医结合医院心胸外科

摘要(Abstract)：

目的:探讨食管癌围手术期Toll样受体4(TLR4)表达与术后急性肺损伤(ALI)的关系。方法:选取行手术治疗的45例食管癌患者,根据术后是否发生ALI分为ALI组和无ALI组,比较两组患者临床资料及手术相关指标,分别于手术单肺通气前(T1)、单肺通气90 min(T2)、单肺通气转为双肺通气后30 min(T3)、术后24 h(T4)时采集中心静脉血,以流式细胞仪检测血浆TLR4的表达,同时检测血清中IL-1β、IL-8、TNF-α炎症因子的浓度,分析TLR4及炎症因子的表达与急性肺损伤的关系。结果:有12例患者术后发生ALI,其发生与患者的年龄、术前肺功能、手术时间、单肺通气时间、术中出血量有关;ALI患者围手术期T2、T3、T4时间点的TLR4表达显著上调,相应时间点的IL-1β、IL-8、TNF-α浓度也明显升高。结论:食管癌围手术期TLR4的高表达与术后急性肺损伤密切相关。
Objective: To investigate the relationship between the expression of toll-like receptor 4( TLR4) of esophagus cancer in the perioperative period and postoperative acute lung injury( ALI).Methods: 45 patients with esophagus cancer who received operative treatment in the hospital from Jan.of 2014 to Apr. of 2017 were selected as objects of the study,and the statistical analysis on relevant preoperative and intraoperative clinical indicators was performed,then the patients were divided into two groups based on whether it had postoperative ALI: Group A( the group with ALI) and Group B( the group without ALI). And the central venous blood was collected before the operation of one-lung ventilation( T1),90 min after one-lung ventilation( T2),30 min after transferring from one-lung ventilation to two-lung ventilation( T3),24 h after operation( T4),and the expression of TLR4 was detected by use of flow cytometer,meanwhile the concentrations of inflammatory factors( IL-1β,IL-8,TNF-α) in the serum were detected,thereby the relationship between the expressions of TLR4 and inflammatory factors and ALI was observed and analyzed. Results: ALI occurred in 12 cases,and it was associated with patients' age,preoperative lung function,operation time,time of one-lung ventilation and intraoperative amount of bleeding. TLR4 showed a significantly up-regulated expression in T2,T3 and T4,and the concentrations of IL-1β,IL-8,TNF-α at these time points also showed an obvious increase. Conclusion: The high expression of TLR4 of esophagus cancer in the perioperative period is closely related to postoperative ALI.

关键词(KeyWords)： 食管肿瘤;外科手术;Toll样受体4;急性肺损伤;围手术期
esophagus neoplasms;operation;Toll-like receptor 4;acute lung injury;perioperative period

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 杜琎,石开虎,胡定辉,李航,刘尊涛,王炜
DU Jin,SHI Kaihu,HU Dinghui,LI Hang,LIU Zuntao,WANG Wei

DOI: 10.19367/j.cnki.1000-2707.2018.08.026

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