Bcl-2和CYP27B1-1260启动子多态性与老年慢性心力衰竭肺部感染易感性的关联  

Association of polymorphisms of Bcl-2 and CYP27B1-1260 promoters with susceptibility to pulmonary infection in elderly patients with chronic heart failure

作　　者：田瑜 崔苗 郭蕾 张岩 申梦莹 TIAN Yu;CUI Miao;GUO Lei;ZHANG Yan;SHEN Meng-ying(The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine,Guiyang,Guizhou 550001,China)

机构地区：[1]贵州中医药大学第一附属医院老年病科,贵州贵阳550001

出　　处：《中华医院感染学杂志》2022年第22期3380-3385,共6页Chinese Journal of Nosocomiology

基　　金：贵州省科技支撑计划基金资助项目(黔科合支撑[2020]4Y125号)。

摘　　要：目的探讨B淋巴细胞瘤-2(Bcl-2)、1α-羟化酶基因(CYP27B1)-1260启动子多态性与老年慢性心力衰竭肺部感染易感性的关联。方法选取2019年10月-2021年12月贵州中医药大学第一附属医院301例老年慢性心力衰竭患者,根据患者发生肺部感染情况,分为感染组67例与未感染组234例,比较两组Bcl-2、CYP27B1-1260启动子基因型与基因频率,通过Logistic回归分析其与老年慢性心力衰竭患者肺部感染的关系。结果感染组67例患者共分离出82株病原菌,革兰阴性菌最多,为60株占比73.17%;单因素及多因素Logistic回归分析结果显示年龄≥70岁、合并糖尿病、合并慢性阻塞性肺疾病、侵入性操作、Bcl-2基因rs2279115位点AA基因型、CYP27B1-1260位点CC基因型是老年慢性心力衰竭患者肺部感染发生的危险因素;感染组Bcl-2基因rs2279115位点AA基因型患者外周血Bcl-2 mRNA表达水平低于AC+CC基因型,CYP27B1-1260位点CC基因型患者外周血1,25(OH)2D3表达水平低于AA+AC基因型(P<0.05)。结论Bcl-2基因rs2279115位点AA基因型、CYP27B1基因-1260位点CC基因型是老年慢性心力衰竭患者肺部感染发生的危险基因型。OBJECTIVE To explore the association of polymorphisms of B-cell lymphoma-2(Bcl-2)and 1α-hydroxylase gene(CYP27B1)-1260 promoters with susceptibility to pulmonary infection in elderly patients with chronic heart failure.METHODS A total of 301 elderly patients with chronic heart failure who were treated in the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from Oct 2019 to Dec 2021 were enrolled in the study and divided into the infection group with 67 cases and the no infection group with 234 cases according to the status of pulmonary infection.The genotypes of Bcl-2 and CYP27B1-1260 promoters and frequencies of genes were compared between the two groups.Logistic regression analysis was performed for their association with the pulmonary infection in the elderly patients with chronic heart failure.RESULTS Totally 82 strains of pathogens were isolated from 67 patients of the infection group,60(73.17%)of which were gram-negative bacteria.The results of univariate analysis and multivariate logistic regression analysis showed that the no less than 70 years of age,complication with diabetes mellitus,complication with chronic obstructive pulmonary disease,invasive operation,AA genotype at rs2279115 locus of Bcl-2 gene and CC genotype at CYP27B1-1260 locus were the risk factors for the pulmonary infection in the elderly patients with chronic heart failure.In the infection group,the expression level of peripheral blood Bcl-2 mRNA of the patients with AA genotype at rs2279115 locus of Bcl-2 gene was lower than that of the patients with AC plus CC genotype,the expression level of peripheral blood 1,25(OH)2D3of the patients with CC genotype at CYP27B1-1260 locus was lower than that of the patients with AA plus AC genotype(P<0.05).CONCLUSION The AA genotype at rs2279115 locus of Bcl-2 gene and CC genotype at CYP27B1-1260 locus are the risk genotypes for the pulmonary infection in the elderly patients with chronic heart failure.

关 键 词：慢性心力衰竭 肺部感染 易感性 B淋巴细胞瘤-2 1α-羟化酶基因 基因多态性 

分 类 号：R541.6[医药卫生—心血管疾病]