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目的 探讨外周血清中Toll样受体4(Toll-like receptor 4,TLR4)水平与缺血缺氧性脑病急性期脑损伤严重程度的关系.方法 30例心肺复苏后缺血缺氧性脑病患者依据格拉斯哥昏迷量表(glasgow coma scale,GCS)评分分为2组,其中轻度脑损伤组14例,重度脑损伤组16例;15例正常健康体检者为正常对照组.所有研究对象应用酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)检测心肺复苏后第1天静脉血清TLR4浓度.结果 各组血清中TLR4浓度:正常组为(0.504±0.056) ng/mL,轻度脑损伤组为(4.236±0.859) ng/mL,重度脑损伤组为(11.159±1.703) ng/mL.统计学分析结果3组间差异有统计学意义(P=0.000),即脑损伤程度越重,血清中TLR4表达水平越高.结论 缺血缺氧性脑病患者急性期的血清TLR4水平可以评估脑损伤的严重程度.“,”Objective To explore the relationship between the expression of toll-like receptor 4 (TLR4) in serum and the brain injury severity of hypoxic-ischemic encephalopathy during acute stage.Methods 30 cases of hypoxic ischemic encephalopathy after cardiopulmonary resuscitation were divided into 2 groups according to the glasgow coma scale (GCS) score,including 14 cases of mild brain injury group,16 cases of severe brain injury group.15 cases of normal healthy persons were selected as control group.The levels of TLR4 in venous serum were detected by enzyme-linked immunosorbent assay (ELISA) in the first day after cardiopulmonary resuscitation.Results The levels of TLR4 in serum was 0.504±0.056 ng/ml in the cont.rol group,4.236±0.859 ng/ml in the mild brain injury group,11.159± 1.703 ng/ml in thesevere brain injury group.Statistical analysis of the differences among the 3 groups was significant (P =0.000),that is,the higher degree of brain injury,the higher level of TLR4 expression in serum.Conclusion The level of serum TLR4 in patients with acute hypoxic ischemic encephalopathy is related to the severity of brain injury.