过氧化物酶体增殖物激活受体γ基因多态性与肺炎脓毒症临床转归的相关性研究  

Relationship of PPARγ gene polymorphisms with the clinical outcome of pneumonia-induced sepsis

作　　者：朱小蔚[1] 黄方[2] 方放[2] 郭蕾 万文辉[2] 刘瑜[2] 

机构地区：[1]南京军区南京总医院保健科,南京210002 [2]南京军区南京总医院干部病房二科,南京210002

出　　处：《医学研究生学报》2017年第12期1300-1304,共5页Journal of Medical Postgraduates

基　　金：国家自然科学基金(81701890);全军保健专项科研课题(13BJZ11)

摘　　要：目的过氧化物酶体增殖物激活受体γ(PPARγ)作为核转录因子能通过多种机制发挥抗炎作用。文中拟在华东汉族人中探讨PPARγ基因多态性与脓毒症临床转归的相关性。方法收集2014年2月至2015年2月南京总医院呼吸科收治的由肺部感染导致的脓毒症患者194例。以改良的多重连接酶检测反应技术对PPARγ基因中13个常见的单核苷酸多态性位点进行基因分型。非条件Logistic回归分析,校正年龄、性别、吸烟/饮酒状态、APACHE II评分等后,在不同遗传模式下分析各位点基因型与脓毒症临床转归(脓毒性休克/器官功能障碍/死亡)的相关性。结果 rs1801282 GC+GG较CC能降低重度器官功能障碍风险[OR(95%CI)=0.11(0.01~0.95),P=0.022];rs2920502 GG较CC+CG死亡风险降低[OR(95%CI)=0.22(0.04~0.99),P=0.043]。结论 PPARγ基因遗传多态性可能与肺炎脓毒症多器官功能障碍和死亡相关;但并未发现变异与脓毒性休克相关。Objective Sepsis is the common cause of death among patients with severe pneumonia. The peroxisome proliferator-activated receptor γ( PPARγ),as a nuclear transcription factor,has an anti-inflammatory action. This study was to investigate the correlation of PPARγ gene polymorphisms with the clinical outcome of sepsis in the Chinese Hans of East China. Methods Using modified multiple ligase detection reaction,we genotyped 13 mononucleotide polymorphism loci of PPARγ in 194 patients with pneumonia-induced sepsis. After adjusting for age,sex,smoking,drinking,and APACHE II scores,we analyzed the correlation of PPARγgene polymorphisms with the clinical outcomes of sepsis by unconditioned logistic regression analysis. Results Compared with the CC genotype,rs1801282 GC+GG significantly decreased the risk of severe organ dysfunction of the patients( OR = 0. 11,95% CI:0.01-0.95,P = 0. 027). In comparison with the CC + CG genotype,rs2920502 GG markedly reduced the risk of death from sepsis( OR= 0.22,95% CI: 0.04-0.99,P= 0.043). Conclusion In the Chinese Hans of East China,PPARγ gene polymorphisms may be associated with multiple organ dysfunction and death of the patients with pneumonia-induced sepsis.

关 键 词：脓毒症 过氧化物酶体增殖物激活受体Γ 单核苷酸多态性 临床转归 

分 类 号：R563.1[医药卫生—呼吸系统]