肿瘤坏死因子-α 308G/A多态性与体外循环瓣膜置换术后急性肾损伤的关系  

Tumor necrosis factor-α 308G/A and cardiac valves replacement surgery with cardiopulmonary bypass associated acute kidney injury in Chinese Han population

作　　者：周晶[1] 巨兰[2] 杨军[3] 戴青青 温良鹤[1] 王雪峰[4] Zhou Jing;Ju Lan;Yang Jun;Dai Qingqing;Wen Lianghe;Wang Xuefeng(Intensive Care Unit, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China;Department of Ultrasound, Daqing Oilfields General Hospital, Daqing 163001, China;Department of Nephrology, Daqing Oilfields General Hospital, Daqing 163001, China;Department of Thoracic Surgery, the First Affiliated Hospital of Harbin Medical University, Harbin 150001, China)

机构地区：[1]哈尔滨医科大学附属第二医院ICU,150086 [2]大庆油田总医院超声科,163001 [3]大庆油田总医院肾内科,163001 [4]哈尔滨医科大学附属第一医院胸外科,150001

出　　处：《中华实验外科杂志》2019年第2期330-332,共3页Chinese Journal of Experimental Surgery

基　　金：黑龙江卫生厅课题 (2012-619).

摘　　要：目的 探讨肿瘤坏死因子-α(TNF-α)308G/A多态性与体外循环瓣膜置换术后急性肾损伤的关系。方法 将223例体外循环瓣膜置换术患者作为研究对象,提取外周血DNA,应用聚合酶链反应-限制性片段长度多态性技术分析TNF-α308G/A多态性,根据A等位基因分为TNF1(GG)和TNF2(GA+AA)两组,比较术后急性肾损伤的发生率。结果 应用Ncol限制性内切酶酶切,AA基因型14例(6%),GG基因型93例(42%),GA基因型116例(52%),等位基因频率A 144例(32%),G 302例(68%),受试人群基因型频率符合Hardy-Weinberg平衡。两组间人口统计学特征、术前心功能、肾功能,糖尿病等危险因素的发病率差异无统计学意义(P>0.05)。围术期体外循环时间、术后机械通气时间、血管活性药应用时间及峰值肌酐水平比较差异无统计学意义(P>0.05),两组术后急性肾损伤的发生率TNF1(GG)组33%,TNF2(GA+AA)组28%,差异无统计学意义(P>0.05)。结论 中国汉族人群TNF-α308G/A多态性与体外循环瓣膜置换术后急性肾损伤无明显相关。Objective To investigate the effect of polymorphism of tumor necrosis factor-α (TNF-α) 308G/A on the risk of cardiac valves replacement surgery with cardiopulmonary bypass associated acute kidney injury in Chinese Han.Methods A total of 223 consecutive patients who underwent cardiac valves replacement surgery with cardiopulmonary bypass at our institution were prospectively enrolled. Patients were genotyped for TNF-α308G/A (rs1800629). According to the A allele, they were divided into two groups: TNF1 (GG) and TNF2 (GA+ AA), and compared the incidence of postoperative acute kidney injury.Results Genotyping revealed for TNF-α308G/A, 14 patients were carriers of the AA allele (6%), 93 patients GG (42%), and 116 patients GA (52%). The genotype frequency conformed to the hardy-weinberg equilibrium. Demographic characteristics and procedural data revealed no significant differences between genotypes. The incidence of postoperative kidney injury was 33%in TNF1 and 28% in TNF2 respectively. No association between TNF-α308G/A genotypes and the KDIGO criteria could be detected.Conclusion TNF-α308G/A polymorphism is not associated with acute renal injury after cardiac valves replacement surgery with cardiopulmonary bypass.

关 键 词：肿瘤坏死因子-α308G/A多态性 体外循环 瓣膜置换术 急性肾损伤 

分 类 号：R654.2[医药卫生—外科学] R692.5[医药卫生—临床医学]