脂多糖结合蛋白基因rs2232618位点多态性与严重创伤后脓毒症易感性及预后价值  

Relationship between the polymorphism of lipopolysaccharide binding protein gene rs2232618 and the susceptibility and prognostic value of sepsis after severe trauma

作　　者：崔峰[1] 赵志坚[1] 陈坤峰[1] 白天峰 史君[1] CUI Feng;ZHAO Zhi-jian;CHEN Kun-feng;BAI Tian-feng;SHI Jun(Shangqiu First People's Hospital,Shangqiu,Henan 476000,China)

机构地区：[1]商丘市第一人民医院急诊外科,河南商丘476000

出　　处：《中华医院感染学杂志》2021年第4期492-496,共5页Chinese Journal of Nosocomiology

基　　金：河南省科研基金资助项目(20182201A-12)。

摘　　要：目的探讨脂多糖结合蛋白(LBP)基因rs2232618位点多态性与严重创伤后脓毒症易感性及预后价值。方法选择商丘市第一人民医院2019年1月-2020年7月收治的创伤性脓毒症患者60例作为研究对象,按照1∶1的比例,选择同期医院收治的未发生脓毒症的创伤患者60例作为对照组。提取两组患者DNA后,通过聚合酶链式扩增反应(PCR)及测序技术检测LBP基因rs2232618位点多态性,分析LBP基因rs2232618位点多态性与创伤脓毒症的易感性及病情、14 d预后的关系。采用受试者工作特征曲线(ROC)对预后的诊断价值进行评价。结果研究组患者LBP基因rs2232618位点TT、CC基因型频率分别为58.33%、11.67%,T、C等位基因频率为73.33%、26.67%,与对照组比较,差异有统计学意义(P<0.05);校正多元Logistic回归分析结果显示,携带TC/CC基因型及C等位基因的创伤患者发生创伤脓毒症的概率是未携带患者的1.344、1.693倍;创伤性脓毒症患者LBP基因rs2232618位点携带TC/CC型患者血清LBP、CD14水平、ISS评分、MODS评分及14 d病死率分别为(92.18±33.06)ng/ml、(89.77±26.30)ng/ml、(28.64±3.13)分、(8.12±1.36)分及60.00%(15/25)高于携带TT型组患者(P<0.05);ROC分析结果显示,血清LBP、CD14水平对于创伤脓毒症患者不良预后的诊断价值,AUC分别为0.756、0.782,差异均有统计学意义(P<0.05)。结论 LBP基因rs2232618位点基因多态性与创伤脓毒症易感性存在关联,C等位基因为易感基因,且血清LBP水平对患者预后具有预测价值。OBJECTIVE To investigate the relationship between the polymorphism of lipopolysaccharide binding protein(LBP) gene rs2232618 and the susceptibility and prognostic value of severe post-traumatic sepsis. METHODS Sixty patients with traumatic sepsis admitted to Shangqiu First People′s Hospital from Jan. 2019 to Jul. 2020 were selected as the research subjects, and 60 trauma patients with no sepsis who were admitted to the hospital during the same period were selected as the control group according to a ratio of 1∶1. After extracting DNA from the two groups of patients, the LBP gene rs2232618 polymorphism was detected by polymerase chain amplification reaction(PCR) and sequencing technology, and the relationship between the LBP gene rs2232618 polymorphism, susceptibility of trauma to sepsis, and the condition and 14 days prognosis was analyzed and traumatic sepsis. The receiver operating characteristic curve(ROC) was used to evaluate the diagnostic value of prognosis. RESULTS The frequencies of TT and CC genotypes at rs2232618 locus of LBP gene in the study group were 58.33% and 11.67%, and the frequencies of T and C alleles were 73.33% and 26.67%(P<0.05). The adjusted multivariate logistic regression analysis showed that the probability of trauma sepsis in trauma patients with TC/CC genotype and C allele was 1.344 and 1.693 times, significantly higher than those without. Serum LBP, CD14 levels, ISS score, MODS score and 14 D mortality rate of patients with traumatic sepsis at rs2232618 of LBP gene carrying TC/CC type was(92.18±33.06) ng/ml,(89.77±26.30) ng/ml,(28.64±3.13) points,(8.12±1.36) points and 60.00%(15/25), respectively, which were significantly higher than those of patients with TT type group(P<0.05). The results of ROC analysis showed that serum LBP and CD14 levels had diagnostic value for the poor prognosis of patients with traumatic sepsis, the AUC were 0.756 and 0.782, respectively, and the differences were significant(P<0.05). CONCLUSION LBP gene rs2232618 locus gene polymorphism is associated

关 键 词：脂多糖结合蛋白 单核苷酸多态性 创伤脓毒症 发病风险 预后价值 

分 类 号：R459.7[医药卫生—急诊医学]