慢性阻塞性肺疾病肺部侵袭性真菌感染危险因素及细胞因子基因多态性  

Gene polymorphisms of cytokines in chronic obstructive pulmonary disease patients with pulmonary invasive fungal infection

作　　者：张黎[1] 蒋艳秋[1] 黄燕[2] 陈敏[3] 阚杰[4] ZHANG Li;JIANG Yan-qiu;HUANG Yan;CHEN Min;KAN Jie(Sichuan Forestry Central Hospital,Chengdu,Sichuan 610000,China)

机构地区：[1]四川省林业中心医院呼吸科,四川成都610000 [2]四川省林业中心医院感染科,四川成都610000 [3]四川省林业中心医院检验科,四川成都610000 [4]四川省林业中心医院护理部,四川成都610000

出　　处：《中华医院感染学杂志》2021年第13期1930-1935,共6页Chinese Journal of Nosocomiology

基　　金：四川省卫生和计划生育委员会基金资助项目(18PJ525)。

摘　　要：目的探究慢性阻塞性肺疾病(COPD)肺部侵袭性真菌感染危险因素及细胞因子基因多态性。方法选取2018年6月-2020年6月四川省林业中心医院接诊的继发肺部侵袭性真菌感染(45例)和未发生肺部真菌感染的COPD患者(65例)为研究对象,分别为真菌感染组和对照组,采用聚合酶链式反应-限制性内切酶法(PCR-RFLP)对白细胞介素(IL)-1β、IL-12和肿瘤坏死因子α(TNF-α)的单核苷酸多态性(SNP)进行基因分型,比较两组患者中上述基因分型的分布特点,并分析继发肺部侵袭性真菌感染的影响因素和病原学特点。结果IL-1β基因rs1143627位点中,两组基因型分布情况比较,无统计学差异,但真菌感染组A等位基因频率高于对照组(P<0.05);IL-12基因rs2243115和rs3212227位点中,两组基因型和等位基因分布比较,差异具有统计学意义(P<0.05);TNF-α基因rs1800629和rs1799724位点中,两组基因型分布比较,无统计学差异,但真菌感染组因rs1800629位点A等位基因、rs1799724位点A等位基因频率均高于对照组(P<0.05);合并糖尿病、低蛋白血症和抗菌药物应用时间≥7 d是COPD患者继发肺部侵袭性真菌感染的独立危险因素(P<0.05)。结论IL-1β、IL-12和TNF-α基因多态性可能与COPD患者继发肺部侵袭性真菌的易感性有关,感染风险还与患者自身状况和治疗因素有关,临床医师应采取相关措施,提高诊疗水平,改善患者预后。OBJECTIVE To explore the gene polymorphisms of cytokines in the chronic obstructive pulmonary disease(COPD)patients with pulmonary invasive fungal infection.METHODS Totally 45 patients with secondary pulmonary invasive fungal infection and 65 COPD patients without pulmonary invasive fungal infection who were treated in the Sichuan Forestry Central Hospital from Jun 2018 to Jun 2020 were enrolled in the study and were repectively assigned as the furgal infection group and the antrol group.The genotyping was conducted for the single nucleotide polymorphism(SNP)of interleukin-1β(IL-1β),interleukin-12(IL-12)and tumor necrosis factor-α(TNF-α)by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP).The genotypes were compared between the two groups of patients,and the influencing factors and etiological characteristics of the secondary pulmonary invasive fungal infection were observed.RESULTS In terms of IL-1βgene at rs1143627 locus,there was no significant difference in the distribution of genotype between the two groups;the frequency of A allele of the fungal infection group was significantly higher than that of the control group(P<0.05).In terms of IL-12 gene at rs2243115 and rs3212227 loci,there were significant differences in the distributions of genotypes and allele between the two groups(P<0.05).In terms of TNF-αgene at rs1800629 and rs1799724 loci,there was no significant difference in the distribution of genotype between the two groups,however,the frequencies of A allele at rs1800629 locus and rs1799724 locus were significantly higher in the fungal infection group than in the control group(P<0.05).Complication with diabetes mellitus,hypoproteinemia and use of antibiotics no less than 7 days were the independent risk factors for the secondary pulmonary invasive fungal infection in the COPD patients(P<0.05).CONCLUSION The polymorphisms of IL-1β,IL-12 and TNF-αgenes may be associated with the susceptibility to secondary pulmonary invasive fungal infection in the COPD patients,and th

关 键 词：白细胞介素 肿瘤坏死因子Α 慢性阻塞性肺疾病 肺部侵袭性真菌感染 基因多态性 易感因素 

分 类 号：R563.9[医药卫生—呼吸系统]