TNF-α及其Ⅱ型受体基因多态性与脑梗死后肺部感染关联性  

Correlation between TNF-αand its receptorⅡgene polymorphisms and pulmonary infection after cerebral infarction

作　　者：彭艳艳[1] 陶中海 庄爱霞[1] 张浩江[1] 聂红霞[1] 伏兵[1] 曾庆宏[1] 周芳[1] PENG Yan-yan;TAO Zhong-hai;ZHUANG Ai-xia;ZHANG Hao-jiang;NIE Hong-xia;FU Bing;ZENG Qing-hong;ZHOU Fang(Second Peoples Hospital of Lianyungang City,Lianyungang,Jiangsu 222000,China)

机构地区：[1]连云港市第二人民医院神经内科,江苏连云港222000

出　　处：《中华医院感染学杂志》2021年第16期2442-2446,共5页Chinese Journal of Nosocomiology

基　　金：蚌埠医学院自然科学基金资助项目(BYKY14140ZD)。

摘　　要：目的分析肿瘤坏死因子-α(TNF-α)及肿瘤坏死因子Ⅱ型受体(TNFRⅡ)基因多态性与脑梗死后肺部感染关联性。方法2017年1月-2020年6月在连云港市第二人民医院神经内科诊治的脑梗死后肺部感染患者、脑梗死后未发生肺部感染患者分别纳入脑梗死后肺部感染组、脑梗死组;选取同期接受健康体检的健康志愿者40名作为对照组;比较三组一般资料,并应用多聚酶链延伸反应-限制性片段长度多态性分析(PCR-RFLP)法测定三组TNF-α(G308A)、TNFRⅡ(T196G)基因多态性;比较三组TNF-α(G308A)、TNFRⅡ(T196G)基因多态性分布情况,Logistic回归分析TNF-α(G308A)、TNFRⅡ(T196G)基因多态性与脑梗死后肺部感染的关系;并比较不同基因多态性的脑梗死后肺部感染患者肺部感染评分(CPIS)。结果三组TNF-α(G308A)、TNFRⅡ(T196G)等位基因频率均符合Hardy-Weinberg定律,三组TNF-α(G308A)基因型频率及等位基因频率差异有统计学意义(P<0.05),TNFRⅡ(T196G)基因型频率及等位基因频率无统计学意义;Logistic回归分析显示完全卧床、侵入性操作、入院时美国国立卫生研究院卒中量表(NIHSS)评分>14分、TNF-α(G308A)基因型-AA型、TNF-α(G308A)等位基因-A均是脑梗死后肺部感染的影响因素(P<0.05);携带TNF-α(G308A)AA基因型、A等位基因患者肺部感染评分(CPIS)高于携带GG、AG基因型及G等位基因患者(P<0.05)。结论脑梗死后肺部感染及其病情与TNF-α(G308A)基因多态性有关,但与TNFRⅡ(T196G)基因多态性无显著相关性。OBJECTIVE To analyze the relationship between tumor necrosis factor-α(TNF-α)and tumor necrosis factor receptorⅡ(TNFRⅡ)gene polymorphisms and pulmonary infection after cerebral infarction.METHODS Patients with pulmonary infection after cerebral infarction and those without pulmonary infection who were diagnosed and treated in the department of neurology at the Second People’s Hospital of Lianyungang City between Jan 2017 and Jun 2020 were enrolled in this study and divided into the pulmonary infection group and cerebral infarction group;40 healthy volunteers during the same period were recruited as the control group.The general data of the three groups were compared.TNF-α(G308 A)and TNFRⅡ(T196 G)polymorphisms were determined by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP)method and compared among the three groups.Logistic regression analysis of the relationship between TNF-α(G308 A)and TNFRⅡ(T196 G)polymorphisms and pulmonary infection after cerebral infarction was performed;the clinical pulmonary infection scores(CPIS)in patients with pulmonary infection after cerebral infarction and different types gene polymorphisms were compared.RESULTS Allele frequencies of TNF-α(G308 A)and TNFRⅡ(T196 G)were in accordance with the Hardy-Weinberg law.There were significant differences in TNF-α(G308 A)genotype frequency and allele frequency among the three groups(P<0.05),while there were no statistically differences in TNFRⅡ(T196 G)genotype frequency and allele frequency among the them.Multivariate Logistic regression analysis showed that complete bed rest,invasive operation,NIHSS score>14 at admission,TNF-α(G308 A)genotype-AA type,and TNF-α(G308 A)allele-A were risk factors for pulmonary infection after cerebral infarction(P<0.05).Patients carrying TNF-α(G308 A)AA genotype and A allele had significantly higher CPIS scores than those carrying GG,AG genotypes and G allele(P<0.05).CONCLUSION Pulmonary infection and its severity after cerebral infarction are related to TNF-α(

关 键 词：脑梗死 肺部感染 肿瘤坏死因子-Α 肿瘤坏死因子Ⅱ型受体 基因多态性 

分 类 号：R563.1[医药卫生—呼吸系统]