IRAKM及IL-1Rα基因多态性与感染性休克的关联  

Association of septic shock with polymorphisms of IRAKM and IL-1Rα genes

作　　者：何文 高媛媛[1] 胡述立[1] 柳梅[1] 范学朋[1] HE Wen;GAO Yuan-yuan;HU Shu-li;LIU Mei;FAN Xue-peng(Wuhan First Hospital,Wuhan,Hubei 430030,China)

机构地区：[1]武汉市第一医院重症医学科,湖北武汉430030

出　　处：《中华医院感染学杂志》2023年第3期345-349,共5页Chinese Journal of Nosocomiology

基　　金：湖北省知识创新专项(自然科学)基金资助项目(2018CFB353)。

摘　　要：目的 分析感染性休克与白细胞介素受体-1相关激酶-M(IRAKM)及白细胞介素-1受体α(IL-1Rα)基因多态性的关联。方法 选取2020年1月-2022年3月武汉市第一医院收治的感染性休克患者81例为研究组,脓毒症未合并感染性休克患者85例为对照组,其中感染性休克患者根据28 d死亡情况分为病死组和存活组。采用限制性片段长度多态性聚合酶链反应(PCR-RFLP)和PCR技术检测外周血IRAKM、IL-1Rα(对应基因IL-1RN)基因多态性,比较各组上述基因分型结果,并分析其与急性生理与慢性健康Ⅱ(APACHEⅡ)评分、序贯器官衰竭(SOFA)评分及重症监护室(ICU)住院时间的关系。结果 研究组IRAKM+22148位点GG基因型及G等位基因分布、IL-1RN*1,2基因型及等位基因2分布频率高于对照组(P<0.05),IRAKM+22148位点GG基因型及G等位基因、IL-1RN*1,2基因型及等位基因2是感染性休克发生的危险因素(P<0.05);病死组IRAKM+22148位点G等位基因分布频率高于存活组(P<0.05),是感染性休克患者病死的危险因素(P<0.05);IRAKM+22148位点GG型患者APACHEⅡ、SOFA评分、CRP及PCT水平高于AA型、AG型(P<0.05);IL-1RN*1,2型SOFA评分、CRP及PCT水平高于1,1型、其他型(P<0.05)。结论 IRAKM+22148位点G等位基因、IL-1RN等位基因2与患者感染性休克密切相关,还会增加患者不良预后的风险。OBJECTIVE To analyze the association of septic shock with polymorphisms of interleukin receptor-1-related kinase-M(IRAKM) and interleukin-1 receptor α(IL-1Rα) genes.METHODS A total of 81 patients with septic shock admitted to Wuhan First Hospital between Jan.2020 and Mar.2022 were selected as the study group,and 85 sepsis patients without septic shock were selected as control group,in which patients with septic shock were divided into the death group and the survival group according to 28 d death status.The polymorphisms of IRAKM and IL-1Rα(IL-1RN) genes in peripheral blood were detected by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) and PCR.The above genotypes in each group were compared,and their relationship with acute physiology and chronic health evaluation II(APACHE II),sequential organ failure assessment(SOFA) scores and stay time in intensive care unit(ICU) was analyzed.RESULTS The frequencies of GG genotype and G allele at IRAKM+22148 locus,and frequencies of IL-1RN*1,2 genotype and allele 2 in the study group were higher than those in the control group(P<0.05).GG genotype and G allele at IRAKM+22148 locus,IL-1RN*1,2 genotype and allele 2 were risk factors for the occurrence of septic shock(P<0.05).The frequency of G allele at IRAKM+22148 locus in death group was higher than that in survival group(P<0.05),which was a risk factor for sickness and death in patients with septic shock(P<0.05).APACHE II and SOFA scores,CRP and PCT levels in patients with GG genotype at IRAKM+22148 locus were higher than those with AA and AG genotypes(P<0.05).SOFA score,CRP and PCT levels in patients with IL-1RN*1,2 genotype were higher than those with 1,1 type and the other genotypes(P<0.05).CONCLUSION The G allele at IRAKM+22148 locus and IL-1RN allele 2 were closely related to the susceptibility of septic shock,which also increased the risk of poor prognosis in patients.

关 键 词：感染性休克 白细胞介素受体-1相关激酶-M 白细胞介素-1rα 基因多态性 预后 关联 

分 类 号：R631.4[医药卫生—外科学]