纤溶酶原激活物抑制剂-1基因启动子区4G/5G多态性与脓毒症患者易感性和预后相关性的研究  

Relationship between sepsis and 4G/5G polymorphism within the promoter region of plasminogen activator inhibitor-1 gene

作　　者：詹芝娅[1] 王宏伟[1] 陈大方[1] 程宝莉[1] 王海宏[1] 方向明[1] 

机构地区：[1]浙江大学医学院附属邵逸夫医院麻醉科

出　　处：《中华医学杂志》2005年第34期2404-2407,共4页National Medical Journal of China

基　　金：国家自然基金资助项目(30471662)

摘　　要：目的探讨血浆纤溶酶原激活物抑制剂-1(PAI-1)基因启动子区单核苷酸缺失/插入(4G/5G)多态性与脓毒症易感性和转归的相关性。方法采用聚合酶链反应、限制性内切酶分析、16%聚丙烯酰胺凝胶电泳结合溴化乙锭染色法,测定89例术后并发严重脓毒症的患者(脓毒症组)和100例术后未并发脓毒症的患者(对照组)PAI-1基因启动子区4G/5G多态性的基因型。结果脓毒症组患者急性生理与慢性健康状况评分Ⅱ评分为22.5±2.1,死亡率为51%;脓毒症组患者PAI-14G/4G基因型携带频率为0.44,4G等位基因携带频率为0.65;对照组分别为0.25和0.50;两组比较差异有统计学意义。脓毒症组中,死亡患者4G/4G基因型携带频率为0.54,存活者为0.34;两者比较差异有统计学意义。结论PAI-1基因启动子区4G/5G多态性与脓毒症的易感性和转归相关,4G纯合子、4G等位基因是脓毒症易感的预警指标,4G纯合子为脓毒症死亡的高危遗传标志。Objective To study the relationship between sepsis and a 4G/5G polymorphism within the promoter region of plasminogen activator inhibitor-1 （PAI-1） gene in the Han nationality. Methods Peripheral blood sample were collected from 89 patients with severe sepsis, 58 males and 31 females, aged 56, with a APHCH Ⅱ score of 22. 5±2. 1 and a mortality of 51%, and 100 sex and agematched postoperative patients without severe sepsis, all of the Han nationality. 4G/5G polymorphism of PAI-1 gene was determined using polymerase chain reaction （PCR） followed by restriction enzyme analysis. Results The carrier rate of 4G/4G genotype among the sepsis patients was 0.44, significantly higher than that among the controls （0.25, P 〈 0. 01 ）. The 4G allele frequency of the sepsis patients was 0. 65, significantly higher than that of the controls （ 0. 54, P 〈 0. 05 ）. The carrier rate of 4G/4G genotype among the non-survivors in the sepsis group was 0. 54 ; significantly higher than that among the survivors （ 0. 34, P 〈0. 05） ; and the 4G allele rate in the non-survivors was 70%, not significantly different from that of the survivors （59% , P 〉 0. 05）. Condusion PAI-1 4G/5G polymorphism is associated with the susceptibility and outcome of severe sepsis, 4G/4G genotype and 4G allele may be genetic risk factors of severe sepsis.

关 键 词：纤溶酶原激活物抑制剂-1 脓毒症 多态现象 4G/5G多态性 基因启动子区 脓毒症患者 相关性的研究 易感性 急性生理与慢性健康状况评分 血浆纤溶酶原激活物抑制剂 

分 类 号：R631[医药卫生—外科学]