CD14基因多态性与老年重症感染易感性及临床结局的关联  

Relationship between CD14 gene polymorphisms and susceptibility to severe infection and clinical outcomes of elderly patients

作　　者：李可[1] 曹丽[1] 李伟[2] 朱媛媛 刘闪闪[1] LI Ke;CAO Li;LI Wei;ZHU Yuan-yuan;LIU Shan-shan(Shangqiu Medical College,Shangqiu,Henan 476000,China;不详)

机构地区：[1]商丘医学高等专科学校,河南商丘476000 [2]商丘市第一人民医院儿二科,河南商丘476000 [3]河南省直第三人民医院外二科,河南郑州450006

出　　处：《中华医院感染学杂志》2022年第4期521-525,共5页Chinese Journal of Nosocomiology

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20190608)。

摘　　要：目的 探究白细胞分化抗原14(CD14)基因多态性与老年重症感染患者血清降钙素原(PCT)及临床结局的关系。方法 选取2019年1月-2020年6月住院治疗的142例老年重症感染患者为重症感染组,根据就诊时急性生理学及慢性健康状况评分系统Ⅱ(APACHEⅡ)评分分为低危组、中危组和高危组,依据临床结局分为病死组和生存组,并选取同期入院就诊的113例上呼吸道感染老年患者为对照组。采用聚合酶链反应-限制性片段长度多态性法检测CD14基因启动子-159位点、-1145位点多态性,比较各组CD14基因-159位点、-1145位点基因型及等位基因频率,并分析其与血清PCT、C-反应蛋白(CRP)水平的关系。结果 重症感染组与对照组CD14基因-159位点、-1145位点基因型及等位基因的分布比较,差异有统计学意义(P<0.05),且重症感染组-159位点C等位基因、-1145位点A等位基因频率低于对照组(P<0.05)。不同临床结局重症感染患者CD14基因-159位点基因型及等位基因、-1145位点基因型的分布比较,差异无统计学意义(P<0.05);但病死组-1145位点A等位基因频率低于生存组(P<0.05)。不同-159位点、-1145位点基因型重症感染患者血清PCT、CRP水平的比较,差异有统计学意义(P<0.05)。结论 CD14基因启动子-159位点、-1145位点多态性是老年患者重症感染易感性和临床结局的影响因素,可能与重症感染炎症反应有关。OBJECTIVE To investigate the relationship between polymorphisms of cluster of differentiation 14(CD14) gene and serum procalcitonin(PCT) and clinical outcomes in elderly patients with severe infection. METHODS A total of 142 elderly patients with severe infection who were hospitalized from Jan 2019 to Jun 2020 were selected as the severe infection group. According to scores of acute physiology and chronic health evaluation scoring system Ⅱ(APACHE II) at the time of consultation, they were divided into low-risk group, intermediate-risk group and high-risk group. According to clinical outcomes, they were divided into death group and survival group, and 113 elderly patients with upper respiratory tract infection admitted to the hospital during the same period were selected as the control group. The polymorphisms of CD14 gene promoters at-159 and-1145 loci were detected by polymerase chain reaction restriction fragment length polymorphism(PCR RFLP). The genotypes and alleles frequencies of CD14 gene at-159 and-1145 loci of each group were compared, and their relationship with serum PCT and C-reactive protein(CRP) levels was analyzed. RESULTS There were significant differences in genotypes and alleles of CD14 gene at-159 and-1145 loci between severe infection group and control group(P<0.05), and the frequencies of C allele at-159 locus and A allele at-1145 locus in severe infection group were significantly lower than those in control group(P<0.05). There was no significant difference in genotypes and alleles of CD14 gene at-159 locus, and genotypes at-1145 locus of severe infection patients with different clinical outcomes(P<0.05). The frequency of A allele at-1145 locus in death group was significantly lower than that in survival group(P<0.05). There were significant differences in levels of serum PCT and CRP of severe infection patients with different genotypes at-159 and-1145 loci(P<0.05). CONCLUSION The polymorphisms of CD14 gene promoters at-159 and-1145 loci was the influencing factor of susceptibility and cli

关 键 词：重症感染 CD14基因多态性 老年 降钙素原 临床结局 

分 类 号：R47[医药卫生—护理学]