基质金属蛋白酶-9 rs3918242位点单核苷酸多态性与胰十二指肠切除术后腹腔感染的关系  

Association between matrix metallopeptidase-9 rs3918242 locus single nucleotide polymorphisms and intra-abdominal infection after pancreaticoduodenectomy

作　　者：陈达伟 汤晓东[1] 陈胜[1] 赵振国[1] 邓志成[1] 贾竞超[1] 周标[1] 刘双海[1] 

机构地区：[1]东南大学医学院附属江阴医院肝胆胰外科,江阴214400

出　　处：《中华实验外科杂志》2017年第12期2230-2233,共4页Chinese Journal of Experimental Surgery

基　　金：江苏省人才工作领导小组办公室“双创博士”项目（201526）;无锡市卫生和计划生育委员会青年卫生科研项目（Q201622）

摘　　要：目的探讨基质金属蛋白酶-9（MMP-9） rs3918242位点单核苷酸多态性与胰十二指肠切除术后腹腔感染的关系。方法纳入152例行胰十二指肠切除术患者，采用Logistic回归方法分析MMP-9 rs3918242多态性在内的21个因素与胰十二指肠切除术后腹腔感染的关系，并比较不同组别患者术后血浆MMP-9浓度差异。结果单因素分析提示胰管直径≥3 mm[比值比（OR）＝0.378，95%可信区间（CI）：0.163，0.874，P＝0.023]、胰腺质地软（OR＝3.414，95%CI：1.353，8.612，P＝0.009）、手术时间≥6 h（OR＝3.018，95%CI：1.302，6.991，P＝0.010）、胰瘘（OR＝6.615，95%CI：2.708，16.161，P＝0.000）、术后腹腔出血（OR＝8.768，95%CI：1.958，39.264，P＝0.005）和rs3918242多态性（CT/TT基因型，OR＝0.211，95%CI：0.060，0.737，P＝0.015）与胰十二指肠切除术后腹腔感染相关。多因素分析结果提示手术时间≥6 h（OR＝4.181，95%CI：1.535，11.384，P＝0.005），胰瘘（OR＝9.713，95%CI：3.507，26.900，P＝0.000）和rs3918242多态性（CT/TT基因型，OR＝0.166，95%CI：0.042，0.646，P＝0.010）与胰十二指肠切除术后腹腔感染相关。rs3918242 CT/TT基因型患者术后血浆MMP-9浓度为（275.2±103.9） ng/ml显著高于CC基因型患者[（240.1±85.2） ng/ml，P＝0.005]，腹腔感染患者术后血浆MMP-9浓度为（205.6±83.1） ng/ml显著低于未腹腔感染患者[（258.5±82.4） ng/ml，P＝0.000]。结论手术时间、胰瘘和MMP-9 rs3918242多态性是胰十二指肠切除术后腹腔感染的独立影响因素，术后较低血浆MMP-9浓度易造成腹腔感染。ObjectiveTo investigate the association between matrix metallopeptidase-9 （MMP-9） rs3918242 locus single nucleotide polymorphisms and intra-abdominal infection after pancreaticoduodenectomy.Methods152 patients undergoing pancreaticoduodenectomy were enrolled, and the association between 21 factors including MMP-9 rs3918242 polymorphisms and intra-abdominal infection after pancreaticoduodenectomy was analyzed using Logistic regression method. Postoperative plasma MMP-9 levels were compared between different groups.ResultsUnivariate analysis revealed pancreatic duct diameter ≥3 mm [odds ratio （OR）=0.378, 95% confidence interval （CI）： 0.163, 0.874, P=0.023], pancreatic texture （soft, OR=3.414, 95% CI： 1.353, 8.612, P=0.009）, operative time ≥6 h （OR=3.018, 95% CI： 1.302, 6.991, P=0.010）, pancreatic fistula （OR=6.615, 95% CI： 2.708, 16.161, P=0.000）, postoperative intra-abdominal bleeding （OR=8.768, 95% CI： 1.958, 39.264, P=0.005）, and rs3918242 polymorphisms CT/TT genotypes （OR=0.211, 95% CI： 0.060, 0.737, P=0.015） were associated with intra-abdominal infection after pancreaticoduodenectomy. Operative time ≥6 h （OR=4.181, 95% CI： 1.535, 11.384, P=0.005）, pancreatic fistula （OR=9.713, 95% CI： 3.507, 26.900, P=0.000）, and rs3918242 polymorphisms CT/TT genotypes （OR=0.166, 95% CI： 0.042, 0.646, P=0.010） were associated with intra-abdominal infection after pancreaticoduodenectomy in multivariate analysis. The patients carrying rs3918242 CT/TT genotypes [（275.2±103.9） ng/ml] had higher postoperative plasma MMP-9 levels than those carrying CC genotype [（240.1±85.2） ng/ml, P=0.005]. Meanwhile, the patients with intra-abdominal infection [（205.6±83.1） ng/ml] had lower postoperative plasma MMP-9 levels than those without intra-abdominal infection [（258.5±82.4） ng/ml, P=0.000].ConclusionOperative time, pancreatic fistula, and rs3918242 polymorphisms were the independent influential factors of intra-abdominal infection after pancreaticoduode

关 键 词：基质金属蛋白酶-9 单核苷酸多态性 腹腔感染 胰十二指肠切除术 胰瘘 

分 类 号：R657.5[医药卫生—外科学]