TLR5基因多态性与泌尿外科术后留置导尿管相关尿路感染的关联  

Association between TLR5 gene polymorphism and postoperative urinary catheter-associated urinary tract infection in urology surgery patients

作　　者：胡月 郑娅婷 汪俊萍 叶莹 尤紫莹 HU Yue;ZHENG Ya-ting;WANG Jun-ping;YE Ying;YOU Zi-ying(Quzhou City Traditional Chinese Medicine Hospital,Quzhou,Zhejiang 324000,China)

机构地区：[1]衢州市中医医院泌尿外科,浙江衢州324000

出　　处：《中华医院感染学杂志》2021年第21期3307-3311,共5页Chinese Journal of Nosocomiology

基　　金：浙江省科研基金资助项目(20192141)。

摘　　要：目的探讨外周血Toll样受体5(TLR5)基因C1174T位点多态性与泌尿外科术后留置导尿管相关尿路感染(CAUTI)的关联。方法选择衢州市中医医院泌尿外科2016年6月-2020年6月进行手术并在术后发生CAUTI患者60例为研究组,选择同期医院泌尿外科进行手术并留置导尿管但在术后未发生CAUTI患者80例为对照组。两组研究对象均在入组时抽取外周静脉血2 ml,采用实时荧光定量聚合酶链式反应检测TLR5基因C1174T位点多态性;采用酶联免疫吸附法检测血清肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)、白细胞介素-17(IL-17)水平。结果研究组住院时间、留置导尿管时间和插管次数均高于对照组,差异具有统计学意义(P<0.05)。研究组TLR5基因C1174T位点TT基因型频率、T等位基因频率高于对照组,差异具有统计学意义(P<0.05)。多因素Logistic回归分析结果发现,住院时间较长、留置导尿管时间较长、插管次数较多、携带TT基因型、T等位基因是泌尿外科术后发生CAUTI的独立危险因素(P<0.05);TT组TLR5 mRNA、TNF-α、IFN-γ、IL-17水平均高于CC/CT组,差异具有统计学意义(P<0.05)。结论外周血TLR5基因C1174T位点多态性与本地区泌尿外科术后CAUTI发生率增加有关,有必要对其进行筛查。OBJECTIVE To explore the relationship between the C1174 T polymorphism of the Toll-like receptor 5(TLR5) gene in peripheral blood and the postoperative urinary catheter-associated urinary tract infection(CAUTI) in urology surgery patients. METHODS From Jun 2016 to Jun 2020, a total of 60 patients who underwent surgery in urology department of Quzhou City Traditional Chinese Medicine Hospital and had postoperative CAUTI were assigned as the study group, meanwhile, 80 patients who received surgery with urinary catheter indwelling but did not have postoperative CAUTI were set as the control group. 2 ml of peripheral venous blood was drawn from each of two groups of study subjects at the enrollment, the C1174 T locus polymorphism of TLR5 gene was detected by using real-time fluorescent quantitative polymerase chain reaction, and the levels of serum tumor necrosis factor-α(TTNF-α), interferon-γ(IFN-γ) and interleukin-17(IL-17) were detected by means of enzyme-linked immunosorbent assay. RESULTS The length of hospital stay, urinary catheter indwelling time and number of times of catheterization were significantly higher in the study group than in the control group(P<0.05). The frequencies of TT genotype at C1174 T locus of TLR5 gene and T allele were significantly higher in the study group than in the control group(P<0.05). The result of multivariate logistic regression analysis showed that the long length of hospital stay, long urinary catheter indwelling time, large number of times of catheterization, TT genotype and T allele were the independent risk factors for the postoperative CAUTI in the urology surgery patients(P<0.05). The levels of TLR5 mRNA, TNF-α, IFN-γ and IL-17 of the TT group were significantly higher than those of the CC/CT group(P<0.05). CONCLUSION The C1174 T polymorphism of TLR5 gene in peripheral blood is associated with the increase of incidence of postoperative CAUTI in the urology surgery patients, and it is necessary to conduct the screening for the patients.

关 键 词：TOLL样受体5 基因多态性 泌尿外科 导尿管相关尿路感染 易感性 

分 类 号：R619.3[医药卫生—外科学]