白三烯A4水解酶基因多态性与结核性脑膜炎病情严重程度的相关性研究  

Research on the relationship between the gene polymorphism of leukotriene A4 hydrolase and the severity of tuberculous meningitis

作　　者：孟兆华[1] 邹月丽[2] 范佳 洪坤[2] 卜晖[2] 何俊瑛[2] Meng Zhaohua;Zou Yueli;Fan Jia;Hong Kun;Bu Hui;He Junying(Department of Emergency,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院急诊科,石家庄050000 [2]河北医科大学第二医院神经内科,石家庄050000

出　　处：《中华神经科杂志》2018年第11期871-876,共6页Chinese Journal of Neurology

摘　　要：目的探讨白三烯A4水解酶（LTA4H）基因rs17525495位点多态性与结核性脑膜炎（TBM）患者病情严重程度的相关性。方法以2014年1月至2016年10月河北医科大学第二医院神经内科收治的184例TBM患者为研究对象，参照英国医学研究会标准将患者病情严重程度分为3期，对患者LTA4H基因单核苷酸多态性位点rs17525495进行基因测序，并对患者的一般病例资料、临床表现、腰椎穿刺术检查结果进行数据描述与分析。结果184例患者中LTA4H基因rs17525495位点CC基因型91例（49.5%），CT型75例（40.8%），TT型18例（9.8%），等位基因频率C为69.8%，T为30.2%。CC型患者中，Ⅰ期患者所占比例（54.9%，50/91）高于Ⅱ（22.0%，20/91）、Ⅲ期（23.1%，21/91）；TT型患者中，Ⅱ（8/18）、Ⅲ期（8/18）患者所占比例高于Ⅰ期（2/18）患者（χ^2=15.898，P=0.003）。对患者头痛、发热、恶心呕吐、颈项强直、癫痫、意识障碍6个方面进行统计分析，发现TT型患者与CC、CT型患者相比，发热（TT型13/18，CC型42/91，CT型50/75，χ^2=8.932，P=0.011）、颈项强直（TT型12/18，CC型38/91，CT型46/75，χ^2=7.993，P=0.018）的发生率更高，不同基因型组间头痛、恶心呕吐、意识障碍、癫痫发生率差异无统计学意义。不同基因型患者间腰椎穿刺压力、氯化物、蛋白质、葡萄糖差异均无统计学意义。结论TBM患者病情较轻时，多提示LTA4H基因rs17525495位点为CC型；病情较重的患者则提示LTA4H基因rs17525495位点为TT型。ObjectiveTo investigate the relationship between rs17525495 locus polymorphism of leukotriene A4 hydrolase （LTA4H） gene and the severity of tuberculous meningitis （TBM）.MethodsA total of 184 TBM patients from Department of Neurology, the Second Hospital of Hebei Medical University from January 2014 to October 2016 were selected as research subjects. According to the British Medical Research Council criteria, the severity of TBM patients was divided into three stages. The single nucleotide polymorphism rs17525495 of LTA4H gene was sequenced, and the general case data, clinical manifestations and results of lumbar puncture were analyzed.ResultsThere were 91 cases （49.5%） of CC genotypes of rs17525495 locus in LTA4H gene of 184 cases, 75 cases （40.8%） of CT genotypes and 18 cases （9.8%） of TT genotypes. The frequency of allele C was 69.8% and T was 30.2%. Patients with different genotypes were compared for their severity, clinical manifestations and lumbar puncture results. Among CC patients, the proportion of stage Ⅰ patients （54.9%, 50/91） was higher than that of stage Ⅱ （22.0%, 20/91） and Ⅲ （23.1%, 21/91） . Among TT patients, the proportion of patients with stage Ⅱ （8/18） and Ⅲ （8/18） was higher than patients with stage Ⅰ （2/18） （χ2=15.898, P=0.003） . The incidence of headache, fever, nausea and vomiting, neck stiffness, epilepsy and disturbance of consciousness was statistically analyzed. Compared with CC and CT patients, the incidence of fever （TT： 13/18, CC： 42/91, CT： 50/75, χ2=8.932, P=0.011） and neck stiffness （TT： 12/18, CC： 38/91, CT： 46/75, χ2=7.993, P=0.018） was higher in TT patients. Headache, nausea and vomiting, disturbance of consciousness, and the incidence of epilepsy showed no statistically significant difference. And there was no statistically significant difference in lumbar puncture pressure, chloride, protein and glucose between different genotypes.ConclusionTBM patients with mild illness frequently prompt LTA4

关 键 词：结核 脑膜 白三烯A4 水解酶类 多态性 单核苷酸 

分 类 号：R529.3[医药卫生—内科学]