支气管肺发育不良与遗传因素的相关分析  

Analysis on Association of Genetic Factors and Bronchopulmonary Dysplasia

作　　者：潘睿[1] 常立文[1] 李文斌[1] 曾凌空[1] 张佳[1] 周玉容[1] 容志惠[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院儿科,武汉430030

出　　处：《实用儿科临床杂志》2012年第16期1230-1232,共3页Journal of Applied Clinical Pediatrics

基　　金：国家自然科学基金(30872795);湖北省自然科学基金(2008CDB139)

摘　　要：目的探讨肺表面蛋白A(SPA)和肺表面蛋白B(SPB)基因多态性与支气管肺发育不良(BPD)的相关性。方法运用PCR-限制性片段长度多态性(RFLP)和基因测序方法检测BPD组(51例)和对照组(103例)新生儿的SPA1AA50G/C、SPA1AA219C/T、SPB-18A/C、SPB1580C/T基因型频率和等位基因频率。结合临床参数,运用χ2检验、Fisher's精确概率法及多因素Lo-gistic回归分析统计学方法分析与BPD发病有关的危险因素。结果 SPA1AA219C/T和SPB1580C/T等位基因和基因型频率在BPD组和对照组中比较差异无统计学意义,而SPA1AA50等位基因G、基因型GG和GC及SPB-18等位基因A、基因型AA和AC分布频率在BPD组中明显高于对照组,差异均有统计学意义(Pa<0.05)。临床参数中,BPD组出生体质量、胎龄、经鼻持续正压通气(CPAP)、机械通气、出生后应用地塞米松、颅内出血和PDA与对照组比较差异均有统计学意义(Pa<0.05)。多因素Logistic回归分析显示,BPD与CPAP、出生后应用地塞米松、颅内出血、SPA1AA50基因型GG和GC及SPB-18基因型AA、AC无关,而与机械通气和PDA呈正相关,与出生体质量、胎龄呈负相关。结论 SPA1AA50G/C、SPB-18A/C不是BPD发病的遗传易感基因。机械通气和PDA是BPD的高危因素,出生体质量和胎龄是其保护因素。Objective To explore the association between bronchopulmonary dysplasia （BPD） and polymorphisms of genes coding for surfactant protein A （SPA） and surfactant protein B （SPB）. Methods A sample of 154 newborns including BPD group （51 cases） and control group （103 cases） were evaluated. Polymorphisms of SPA1 AASOG/C, SPA1 AA219C/T, SPB - 18A/C and SPB1580C/T were as- sessed using polymerase chain reaction - restriction fragment length polymorphism（ PCR - RFLP） and gene sequencing. The X^2 test, Fisher＇s exact test and multivariate Logistic regression analysis were performed by all factors. Results The frequency of polymorphisms of SPA1 AA219C/T and SPB1580C/T were similar between BPD group and control group. The newborns with genotypes GG, GC or allele G of SPA1 AASO, and genotypes AA, AC or allele A of SPB -18 were significantly higher in BPD group than those in control group （Pa 〈 0.05 ）. There were statistical differences in birth weight, gestational age, continuous positive airway pressure, mechanical ventilation, post- natal dexametha- sone administration, cerebral hemorrhage and patent ductus arteriosus（PDA） between BPD group and control group （Pa 〈 0.05 ）. Multivariate Logistic regression analysis showed that mechanical ventilation and PDA were positively related to BPD, and birth weight and gestational age were negatively related to BPD, while CPAP, post - natal dexamethasone administration, cerebral hemorrhage, GG, GC of SPA1 AA50 genotypes and AA,AC of SPB - 18 genotypes were not related to BPD. Conclusions Polymorphism of SPA1 AASOG/C and SPB - 18A/C did not inf- luence the risk of BPD individually. Mechanical ventilation and PDA are the risk factors for BPD, while birth weight and gestational age are the protective factors.

关 键 词：肺表面蛋白 支气管肺发育不良 等位基因 

分 类 号：R722.6[医药卫生—儿科]