Probing the mechanism of Toll-like receptor 4/ nuclear factor-kappa B signaling pathway-based action of hemoperfusion combined with hemofiltration on sepsis-induced inflammatory injury in vascular endothelial tissue
10.3760/cma.j.cn115455-20230506-00477
- VernacularTitle:基于Toll样受体4/核因子-κB信号通路探究血液灌流联合血液滤过对脓毒症诱导的血管内皮组织炎性损伤的作用机制
- Author:
Huan WANG
1
;
Junying DONG
;
Haiyan ZHOU
;
Can CHANG
Author Information
1. 菏泽市立医院重症医学科，菏泽 274000
- Keywords:
Sepsis;
Hemoperfusion;
Hemofiltration;
Toll-like receptor 4;
Nuclear factor-kappa B
- From:
Chinese Journal of Postgraduates of Medicine
2024;47(6):550-555
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the mechanism of hemoperfusion combined with hemofiltration in the treatment of sepsis based on Toll-like receptor 4 (TLR4)/nuclear factor-κB (NF-κB) signaling pathway.Methods:One hundred and fifty patients with sepsis treated in the Heze Municipal Hospital from February 2020 to February 2023 were retrospectively selected and they were divided into two groups according to the treatment plan, with 75 cases in each group. Both groups were treated with standard treatment for sepsis, with hemofiltration in the control group and hemoperfusion combined with hemofiltration in the observation group. The TLR4/NF-κB signal pathway-related mRNA expression (TLR4 mRNA, NF-κB mRNA), related inflammatory factors, indicators of vascular endothelial function, the levels of indicators of liver and kidney function were measured between the two groups. The 28-d morbidity and mortality rate was compared between the two groups.Results:Compared with before treatment, the levels of TLR4 mRNA, NF-κB mRNA in two groups were decreased, and the levels of above index in the observation group were lower than those in the control group: 0.34 ± 0.12 vs. 0.63 ± 0.16, 0.30 ± 0.10 vs. 0.59 ± 0.12, there were statistical differences ( P<0.05). Compared with before treatment, the levels of tumour necrosis factor-α (TNF-α), interleukin-6 (IL-6), IL-12 and C reactive protein (CRP) in two groups were decreased, and the levels of above index in the observation group were lower than those in the control group: (43.42 ± 7.82) ng/L vs. (56.37 ± 9.41) ng/L, (28.47 ± 6.03) ng/L vs. (39.41 ± 7.02) ng/L, (52.31 ± 5.42) ng/L vs. (70.84 ± 7.08) ng/L, (23.82 ± 7.06) mg/L vs. (38.41 ± 6.83) mg/L, there were statistical differences ( P<0.05). Compared with before treatment, the levels of advanced glycosylation end products (AGEs), soluble intercellular adhesion factor-1 (sICAM-1), homocysteine (Hcy), glutamate transaminase (ALT), glutathione transaminase(AST), blood creatinine (Scr) and blood urea nitrogen (BUN) in two groups were decreased, and the levels of above index in the observation group were lower than those in the control group: (172.37 ± 73.63) mg/L vs. (249.41 ± 80.26) mg/L, (404.26 ± 68.42) ng/L vs. (459.36 ± 70.19) ng/L, (20.27 ± 4.53) μmol/L vs. (28.96 ± 5.02) μmol/L, (62.41 ± 10.69) U/L vs. (78.52 ± 13.41) U/L, (51.47 ± 12.35) U/L vs. (64.17 ± 15.83) U/L, (3.82 ± 0.79) mmol/L vs. (5.57 ± 1.16) mmol/L, (125.16 ± 23.96) μmol/L vs. (163.24 ± 30.12) μmol/L, there were statistical differences ( P<0.05). The 28-d morbidity and mortality rate in the observation group was lower than that in the control group: 12.00%(9/75) vs. 25.33%(19/75), there was statistical difference ( χ2 = 4.39, P<0.05). Conclusions:In the treatment of sepsis, hemoperfusion combined with hemofiltration can effectively alleviate the severity of the disease, reduce the damage of hepatic and renal function, and have a certain effect on the mRNA expression of TLR4/NF-κB signaling pathway and related inflammatory factors.
