机构地区:[1]宁波大学医学院附属医院重症医学科,浙江宁波315020
出 处:《中华医院感染学杂志》2020年第23期3539-3543,共5页Chinese Journal of Nosocomiology
基 金:宁波市医学科技计划基金资助项目(2018A10)。
摘 要:目的探讨基质金属蛋白酶-9(Matrix metalloprotein-9,MMP-9)1562 C/T与脓毒症易感性及血清MMP-9预后价值。方法选择宁波大学医学院附属医院重症医学科2018年2月-2020年2月收治的脓毒症患者65例作为研究组,选择同期医院进行外科大手术后未引发脓毒症患者60例作为对照组。采用Taqman探针法MMP-9-1562 C/T位点基因型及等位基因频率,采用受试者工作特征曲线(Receiver operating characteristic,ROC)评价血清MMP-9对研究组患者预后评估价值,分析血清MMP-9水平与研究组患者疾病评分序贯器官衰竭评分(Sequential organ failure score,SOFA),急性生理和慢性健康评分(Acute Physiological and Chronic Health Score,APACHEⅡ)评分,血乳酸、C-反应蛋白(C reactive protein,CRP)、降钙素原(Procalcitonin,PCT)、中性粒细胞/淋巴细胞比值(Neutrophil/lymphocyte ratio,NLR)相关性。结果研究组患者CC基因型、C等位基因频率为47.06%、58.09%,低于对照组,TT基因型、T等位基因型频率高于对照组(P<0.05)。在校正年龄、性别等混杂因素后,携带CT、TT基因型、T等位基因患者相对携带与CC基因型、C等位基因脓毒症发病风险增加;研究组患者MMP-9-1562 C/T位点携带CT+TT基因型患者血清MMP-9、SOFA、APACHEⅡ、血乳酸、CRP、PCT、NLR水平均高于携带CC基因型患者(P<0.05);ROC分析结果显示,血清MMP-9水平对于脓毒症患者预后具有较好的预测效果,其曲线下面积为0.790,95%CI值为0.705~0.875。结论 MMP-9-1562 C/T位点基因多态性与脓毒症易感性存在关联,该结论有待更大样本的检验,血清MMP-9水平对于患者预后具有一定的预测价值。OBJECTIVE To investigate the correlation between matrix metalloprotein-9(MMP-9) 1562 C/T and susceptibility to sepsis and the prognostic value of serum MMP-9. METHODS Total of 65 patients with sepsis admitted to the Department of Intensive Medicine of the Affiliated Hospital of Ningbo University School of Medicine from Feb. 2018 to Feb. 2020 were recruited as the research group, and 60 patients having major surgical operations without sepsis during the same period were in the control group. MMP-9-1562 C/T locus genotype and allele frequency were detected by using Taqman probe method. Receiver operating characteristic(ROC) was used to evaluate the prognostic value of serum MMP-9 in the study group. Serum level of MMP-9, the Sequential Organ Failure Score(SOFA), Acute Physiological and Chronic Health Score(APACHE II) score, blood lactic acid, C response Correlation of protein(C reactive protein, CRP), procalcitonin(PCT) and neutrophil/lymphocyte ratio(NLR) were analyzed. RESULTS The CC genotype and C allele frequency in the study group(47.06% and 58.09%) were significantly lower than that in the control group, whereas the TT genotype and T allele frequency were significantly higher than that in the control group(P<0.05). After adjusting for confounding factors such as age and gender, we found that patients with CT and TT genotype and T alleles had an increased risk of sepsis than that with CC genotype and C alleles. Serum MMP-9 level, SOFA, APACHE Ⅱ, blood lactate, CRP, PCT and NLR levels in patients with CT+TT genotype at MMP-9-1562 C/T locus were significantly higher than that with CC genotype(P<0.05). ROC analysis showed that serum MMP-9 level had a good predictive effect on the prognosis of patients with sepsis, with an area under the curve of 0.790 and 95% CI value of 0.705 to 0.875. CONCLUSION MMP-9-1562 C/T locus gene polymorphism may be associated with sepsis susceptibility and should be verified by a larger sample. Serum MMP-9 level may have certain predictive value for the prognosis of patients and be w
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