感染致急性肺损伤患者预后与血管紧张素转换酶基因多态性的关系  

Relationship between angiotensin converting enzyme gene polymorphism and the prognosis of patients with acute lung injury caused by infection

作　　者：李勋济 柳俊杰 冯俊亚 尹玲玲 LI Xun-ji;LIU Jun-jie;FENG Jun-ya;YIN Ling-ling(The Third People's Hospital of Jiujiang City,Jiangxi Province,Jiujiang,Jiangxi 332000,China)

机构地区：[1]江西省九江市第三人民医院呼吸二科,江西九江332000

出　　处：《中华医院感染学杂志》2021年第11期1676-1680,共5页Chinese Journal of Nosocomiology

基　　金：江西省卫生计生委科技计划基金资助项目(20187138)。

摘　　要：目的探讨血管紧张素转换酶(ACE)基因多态性与感染致急性肺损伤(ALI)患者预后的关系。方法选择2018年1月-2020年1月九江市第三人民医院重症监护病房(ICU)收治的感染致ALI的91例患者设为ALI组,同期ICU收治非ALI患者55例设为非ALI组,采血测定ACE水平,提取全血基因组DNA,限制性长度片段多态性(RFLP)聚合酶链反应法(PCR)测定ACE基因多态性,分析ACE基因多态性与感染致ALI易感性及近期预后关系。结果ALI组携带D/D基因型比例、携带D等位基因频率分别为46.15%(42/91),57.69%(105/182)高于非ALI组(P<0.05),ACE为(141.52±15.63)ng/ml低于非ALI组(P<0.05);随访6个月近期存活患者携带D/D型基因型和D等位基因型比例分别为38.57%(27/70)、51.43%(72/140)低于死亡患者(P<0.05);携带I/I基因型ALI患者机械通气时间、ICU住院时间分别为(3.19±0.78)d、(5.61±1.62)d短于携带D/D型与I/D型患者,血清ACE为(159.48±34.74)ng/ml,高于携带D/D型、I/D型患者;近期存活率为92.86%(26/28)高于携带D/D型、I/D型患者(P<0.05);携带I/D型患者机械通气时间、ICU住院时间短于携带D/D型患者,血清ACE水平高于携带D/D型患者,近期存活率高于携带D/D型患者(P<0.05);ALI存活患者血清ACE为(161.88±40.66)ng/ml,高于死亡患者(P<0.05);携带ACE基因D/D型、等位基因D可使ALI发生风险增加2.045倍、1.201倍;携带D/D基因型、等位基因D可使ALI不良预后风险增加1.736倍、1.175倍。结论携带ACE D/D基因型及等位基因D可增加感染致ALI易感性及不良预后发生风险。OBJECTIVE To investigate the relationship between angiotensin converting enzyme(ACE)gene polymorphism and the prognosis of patients with acute lung injury(ALI)induced by infection.METHODS Totally 91 patients with ALI admitted to the intensive care unit(ICU)of the Third People′s Hospital of Jiujiang City from Jan.2018 to Jan.2020 were selected as ALI group,and 55 patients without ALI admitted to the ICU during the same period were selected as non-ALI group.Blood was collected to determine ACE level,and whole blood genomic DNA was extracted.The restriction fragment length polymorphism(RFLP)polymerase chain reaction(PCR)method was used to detect ACE gene polymorphism.The relationship between ACE gene polymorphism and susceptibility to infection-induced ALI and short-term prognosis was analyzed.RESULTS The proportions of D/D genotype and the frequency of the allele D in the ALI group were 46.15%(42/91)and 57.69%(105/182),respectively,significantly higher than those in non-ALI group(P<0.05),while the ACE was(141.52±15.63)ng/ml,significantly lower than that in non-ALI group(P<0.05).The proportions of patients with D/D genotype and allele D in the recent 6-months follow-up were 38.57%(27/70)and 51.43%(72/140),respectively,significantly lower than those in dead patients(P<0.05).The mechanical ventilation time and ICU hospitalization time of ALI patients with I/I genotype were(3.19±0.78)d and(5.61±1.62)d,respectively,significantly shorter than those with D/D genotype and I/D genotype.Serum ACE was(159.48±34.74)ng/ml,significantly higher than those with D/D genotype and I/D genotype.The short-term survival rate was 92.86%(26/28),significantly higher than those with D/D genotype and I/D genotype(P<0.05).Additionally,the mechanical ventilation time and ICU hospitalization time of patients with I/D genotype were significantly shorter than those of patients with D/D genotype.The serum ACE level was significantly higher than that of patients with D/D genotype,and the short-term survival rate was significantly higher than

关 键 词：血管紧张素转换酶 基因多态性 急性肺损伤 感染 易感性 预后 

分 类 号：R563[医药卫生—呼吸系统]