Objective:To study the expression of TLR4 in peripheral blood mononuclear cells with myocardial injury and inflammatory stress response in patients with acute myocardial infarction .Methods:Patients who were diagnosed with acute myocardial infarction ,unstable angina pectoris and stable angina pectoris in the People's Hospital of Huangmei between June 2014 and August 2017 were enrolled in the AMI group ,UAP group and SAP group of the study respectively ,and the volunteers who received physical examination in the People's Hospital of Huangmei during the same period were selected as the control group .The expression levels of TLR4 and stress indexes in peripheral blood mononuclear cells as well as the levels of myocardial injury indexes ,inflammation indexes and stress indexes in serum were measured .Results:TLR4 ,Nrf2 ,NQO-1 and γ-GCS mRNA expression in peripheral blood mononuclear cells as well as CK ,LDH ,CK-MB ,cTnT ,MMP9 ,HMGB1 ,sVCAM1 ,IFN-γ,IL-17 ,MDA and AOPP levels in serum of AMI group were higher than those of UAP group ,SAP group and control group;TLR4 mRNA expression in peripheral blood mononuclear cells of patients with AMI was positively correlated with CK ,LDH ,CK-MB ,cTnT ,MMP9 ,HMGB1 ,sVCAM1 ,IFN-γ,IL-17 ,MDA and AOPP levels in serum as well as Nrf2 ,NQO-1 and γ-GCS mRNA expression in peripheral blood .Conclusion:The high expression of TLR4 in peripheral blood mononuclear cells of patients with acute myocardial infarction can aggravate the myocardial injury and promote the activation of inflammatory stress response .%目的:研究急性心肌梗死患者外周血单个核细胞T L R4表达量与心肌损伤、炎症应激反应.方法:选择在本院诊断为急性心肌梗死、不稳定型心绞痛、稳定型心绞痛的病例分别纳入研究的AMI组、UAP组、SAP组,另取同期在黄梅县人民医院健康体检的志愿者作为对照组.测定外周血单个核细胞中TLR4、应激指标的表达量以及血清中心肌损伤指标、炎症指标、应激指标的含量.结果:AMI组外周血中单个核细胞中TLR4、Nrf2、NQO-1、γ-GCS的mRNA表达量以及血清中CK、LDH、CK-MB、cTnT、MMP9、HMGB1、sVCAM1、IFN-γ、IL-17、MDA、AOPP的含量均高于UAP组、SAP组及对照组;AMI患者外周血单个核细胞中TLR4的mRNA表达量与血清中CK、LDH、CK-MB、cTnT、MMP9、HMGB1、sVCAM1、IFN-γ、IL-17、MDA、AOPP的含量以及外周血中Nrf2、NQO-1、γ-GCS的mRNA表达量呈正相关.结论:急性心肌梗死患者外周血单个核细胞TLR4的高表达能够加重心肌损伤、促进炎症应激反应激活.
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