IFN-γ及TGF-β1基因多态性与高龄产妇剖宫产术后感染的关联  

Correlation between polymorphis of IFN-γand TGF-β1 genes and infection in elderly puerperae after cesarean section

作　　者：单小飞 王晓明[1] 郭芳芳[1] 宋娇 郭慧超 SHAN Xiao-fei;WANG Xiao-ming;GUO Fang-fang;SONG Jiao;GUO Hui-chao(Shengjing Hospital Affiliated to China Medical University,Shenyang,Liaoning 110000,China)

机构地区：[1]中国医科大学附属盛京医院第一产科病房,辽宁沈阳110000

出　　处：《中华医院感染学杂志》2022年第15期2363-2367,共5页Chinese Journal of Nosocomiology

基　　金：辽宁省科研基金资助项目(2020JH2114)。

摘　　要：目的探讨高龄产妇剖宫产术后感染与干扰素-γ(IFN-γ)、转化生长因子-β1(TGF-β1)基因多态性的相关性。方法选取2019年1月-2021年10月中国医科大学附属盛京医院接受剖宫产手术并发生感染的98例高龄产妇作为感染组,另选取同期行剖宫产手术但未发生感染的高龄产妇80例作为非感染组。检测感染组病原菌分布情况,并对比两组外周血的IFN-γ、TGF-β1基因分型分布情况,采用多因素回归分析和受试者工作特征曲线(ROC)分析IFN-γ、TGF-β1基因多态性与高龄产妇剖宫产术后感染的关系。结果感染组患者共检出病原菌116株,革兰阴性菌占51.72%,革兰阳性菌占43.97%,真菌占4.31%。感染组IFN-γ基因rs2430561位点AA基因型、A等位基因高于非感染组(P<0.05)。感染组TGF-β1基因-509C/T位点CC基因型、C等位基因高于非感染组(P<0.05)。多因素回归分析结果显示,侵入性操作次数≥4次、胎膜早破、手术时间≥1 h、IFN-γrs2430561位点AA型和TGF-β1-509C/T位点CC型是高龄产妇剖宫产术后发生感染的影响因素(P<0.05)。ROC曲线分析显示,IFN-γ、TGF-β1基因多态性联合预测高龄产妇剖宫产术后感染的ROC曲线下面积高于二者单项预测(P<0.05)。结论IFN-γrs2430561位点AA型和TGF-β1-509C/T位点CC型可能增加高龄产妇剖宫产术后感染的发生风险。OBJECTIVE To explore the correlation between infection and polymorphisms of interferon-γ(IFN-γ)and transforming growth factor-β1(TGF-β1)genes in elderly puerperae after cesarean section.METHODS A total of 98 elderly puerperae with infection after cesarean section in Shengjing Hospital affiliated to China Medical University between Jan 2019 and Oct 2021 were enrolled as the infection group,and other 80 elderly puerperae without infection during the same period were enrolled as the non-infection group.The distribution of pathogens in the infection group was detected.The genotypes of IFN-γand TGF-β1 between the two groups were compared.The relationship between polymorphis of IFN-γand TGF-β1 genes and infection after cesarean section was analyzed by multivariate regression analysis and receiver operating curve(ROCs).RESULTS There were 116 strains of pathogens in the infection group,including Gram-negative bacteria(51.72%),Gram-positive bacteria(43.97%)and fungi(4.31%).The frequency of AA genotype and A allele at IFN-γgene rs2430561 locus in the infected group were significantly higher than that in the non-infected group(P<0.05).The frequency of TT genotype and T allele at TGF-β1 gene-509 C/T locus were significantly higher than that in the non-infected group(P<0.05).Multivariate regression analysis showed that invasive operation≥4 times,premature rupture of membranes,operation time≥1 h,AA genotype at IFN-γrs2430561 locus and CC genotype at TGF-β1-509 C/T locus were important risk factors for infection after cesarean section.ROC curve analysis showed that the area under the ROC curve(AUC)of IFN-γcombined with TGF-β1 gene polymorphisms for predicting infection after cesarean section was significantly larger than that of individual index(P<0.05).CONCLUSION AA genotype at IFN-γrs2430561 locus and CC genotype at TGF-β1-509 C/T locus may increase infection risk in elderly puerperae after cesarean section.

关 键 词：高龄产妇 剖宫产 术后感染 干扰素-Γ 转化生长因子-Β1 基因多态性 关联 

分 类 号：R619[医药卫生—外科学]