纤溶酶原激活物抑制剂-1基因多态性与新生儿败血症易感性的关联  

Association of plasminogen activator inhibitor-1 gene polymorphism with susceptibility to neonatal sepsis

作　　者：祁宏亮[1] 李莎莎[2] 武彦秋[1] 赵宏伟[1] 白雪[1] 周启立[1] QI Hong-liang;LI Sha-sha;WU Yan-qiu;ZHAO Hong-wei;BAI Xue;ZHOU Qi-li(Affiliated Hospital of Chengde Medical College,Chengde,Hebei 067000,China;不详)

机构地区：[1]承德医学院附属医院新生儿科,河北承德067000 [2]承德医学院生理学教研室,河北承德067000

出　　处：《中华医院感染学杂志》2022年第3期471-475,共5页Chinese Journal of Nosocomiology

基　　金：河北省卫健委医学科学研究基金资助项目(20210992)。

摘　　要：目的 探讨纤溶酶原激活物抑制剂-1(PAI-1)基因多态性与新生儿败血症易感性的关联。方法 选择承德医学院附属医院新生儿科2018年1月—2020年12月进行治疗的新生儿败血症患儿98例为病例组,随机选择同期医院新生儿科健康足月新生儿90例为对照组。通过血培养确定新生儿败血症感染病原菌种进行鉴定;检测外周血C-反应蛋白(CRP)和白细胞介素-6(IL-6)以及凝血功能指标抗凝血酶Ⅲ(AT-Ⅲ)、D-二聚体(DD)及血小板(PLT)水平;采用聚合酶链式扩增反应和一代测序法检测PAI基因rs1799768位点基因多态性。结果 98例血培养阳性败血症新生儿共检出革兰阳性菌84例,占85.71%,革兰阴性菌14例,占比14.29%,金黄色葡萄球菌、B族链球菌和粪肠球菌为检出率最高的病原菌。病例组4G/5G位点基因型频率高于对照组,差异具有统计学意义(P<0.05),两组4G/4G、5G/5G基因型及4G、5G等位基因频率比较,无统计学差异;革兰阴性菌感染与革兰阳性菌感染败血症新生儿PAI基因4G/5G位点基因型、等位基因分布比较,无统计学差异;三组PAI-1基因多态性CRP、IL-6、AT-Ⅲ、DD及PLT水平整体比较差异具有统计学意义(P<0.05);4G/5G型败血症患儿CRP、IL-6、DD水平高于其他两组,AT-Ⅲ、PLT水平低于其他两组,差异均具有统计学意义(P<0.05)。结论 PAI基因rs1799768位点4G/5G基因型显著增加新生儿败血症风险,但与感染病原类型无关,其机制可能与影响纤溶系统有关。OBJECTIVE To investigate the relationship between plasminogen activator inhibitor-1(Plasminogen Activator Inhibitor-1, PAI) gene polymorphism and the susceptibility to neonatal sepsis. METHODS 98 cases of neonatal septicemia patients who were treated in the Department of Neonatology of the Affiliated Hospital of Chengde Medical College from Jan 2018 to Dec 2020 were selected as the case group, and 90 cases of healthy term neonates in the Department of Neonatology of the Hospital during the same period were randomly selected as the control group. The pathogenic bacteria of neonatal sepsis were identified by blood culture;The peripheral blood C-reactive protein(CRP), interleukin-6(IL-6), blood coagulation function index antithrombin Ⅲ(AT-Ⅲ) at the time of enrollment), D-dimer(DD) and platelet(PLT) levels were detected;Polymerase chain amplification reaction and first-generation sequencing were used to detect the genetic polymorphism of PAI gene rs1799768. RESULTS A total of 84 gram-positive bacteria were detected in 98 neonates with positive blood culture sepsis, accounting for 85.71%, 14 cases of gram-negative bacteria, accounting for 14.29%, and Staphylococcus aureus, Group B Streptococcus and Enterococcus faecalis were the pathogens with the highest detection rate. The genotype frequency of 4 G/5 G locus in the case group was significantly higher than that in the control group(P<0.05). There was no significant difference between the two groups of 4 G/4 G, 5 G/5 G genotypes and 4 G, 5 G allele frequencies. There was no significant difference between the 4 G/5 G locus genotype and allele distribution of the PAI gene in newborns with gram-negative bacteria infection and gram-positive bacteria infection with sepsis;The overall comparison of the levels of CRP, IL-6, AT-Ⅲ, DD and PLT of the three groups of PAI-1 gene polymorphisms was significant(P<0.05);the levels of CRP, IL-6 and DD in sepsis children with 4 G/5 G genotype were significantly higher than those of the other two groups, while the AT-Ⅲ and PLT l

关 键 词：纤溶酶原激活物抑制剂-1 基因多态性 新生儿 败血症 凝血功能 

分 类 号：R722.131[医药卫生—儿科]