VDR基因多态性与长期血液透析导管相关性血流感染的关联  

Association of catheter-related bloodstream infection in long-term hemodialysis with VDR gene polymorphism

作　　者：李晓华[1] 徐海燕[1] 曲艳[1] 李芳芳[1] LI Xiao-hua;XU Hai-yan;QU Yan;LI Fang-fang(Yantai Yuhuangding Hospital,Yantai,Shandong 264000,China)

机构地区：[1]烟台毓璜顶医院血液净化科,山东烟台264000

出　　处：《中华医院感染学杂志》2023年第3期376-380,共5页Chinese Journal of Nosocomiology

基　　金：山东省自然科学基金资助项目(2020H52)。

摘　　要：目的 探究长期血液透析患者导管相关性血流感染(CRBSI)与维生素D受体(VDR)基因多态性的关联。方法 选取2020年1-12月烟台毓璜顶医院血液透析中心130例长期血液透析患者为研究对象,根据是否发生CRBSI分为感染组(n=34)、对照组(n=96)。采用聚合酶链反应-限制性片段长度(PCR-RELP)法检测VDR基因ApaⅠ(rs7975232)位点多态性,并检测血清25羟维生素D_(3)[25(OH)D_(3)]、降钙素原(PCT)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平,分析发生CRBSI的影响因素。结果 两组VDR基因ApaⅠ位点基因型实际频数与理论频数差异均无统计学意义,有群体代表性;感染组VDR基因ApaⅠ位点CC基因型频率低于对照组(P<0.05),AA基因型、A等位基因频率均高于对照组(P<0.05);感染组血清25(OH)D_(3)低于对照组(P<0.05),PCT、IL-6、TNF-α高于对照组(P<0.05);感染组中AC型、AA型血清25(OH)D_(3)低于CC型(P<0.05),血清PCT、IL-6、TNF-α均高于CC型(P<0.05);多因素Logistic回归分析显示,VDR基因ApaⅠ位点AA基因型、A等位基因是长期透析患者发生CRBSI的危险因素(P<0.05),血清25(OH)D_(3)是其保护因素(P<0.05)。结论 长期血液透析患者CRBSI发病与VDR基因多态性有关,同时还受[25(OH)D_(3)]水平及相关炎症因子影响。OBJECTIVE o investigate the association of catheter-related bloodstream infection(CRBSI) with vitamin D receptor(VDR) gene polymorphism in long-term hemodialysis patients.METHODS Totally 130 patients with long-term hemodialysis in hemodialysis center of Yantai Yuhuangding Hospital between Jan.2020 and Dec.2020 were selected as the study subjects,and were divided into infection group(n=34) and control group(n=96) according to whether CRBSI occurred.Polymerase chain reaction-restriction fragment length polymorphism(PCR-RELP) was used to detect the polymorphism of VDR gene at Apa I(rs7975232) locus,and the levels of serum vitamin D[25(OH)D_(3)],procalcitonin(PCT),interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) were detected,and the influencing factors of CRBSI occurrence were analyzed.RESULTS There were no statistical differences between the actual frequencies and the theoretical frequencies of genotypes at Apa I locus of VDR gene in the two groups,which were representative of the group.The frequency of CC genotype at Apa I locus of VDR gene in infection group was lower than that in control group(P<0.05),while the frequencies of AA genotype and A allele were higher than those in control group(P<0.05).The level of serum 25(OH)D_(3) in infection group was lower than that in control group(P<0.05),while the levels of PCT,IL-6 and TNF-α were higher than those in control group(P<0.05).In the infection group,the level of serum 25(OH)D_(3) of patients carrying AC genotype or AA genotype was lower than that of patients carrying CC genotype(P<0.05),while the levels of serum PCT,IL-6 and TNF-α were higher than those of patients carrying CC genotype(P<0.05).Multivariate Logistic regression analysis showed that AA genotype and A allele at Apa I locus of VDR gene were the influencing factors for CRBSI in patients with long-term hemodialysis(P<0.05),and serum 25(OH)D_(3) was its protective factor(P<0.05).CONCLUSION The development of CRBSI in patients with long-term hemodialysis was associated with VDR gene polymorphism

关 键 词：血液透析 导管相关性血流感染 影响因素 维生素D受体 基因多态性 关联 

分 类 号：R473[医药卫生—护理学]