Nrf2基因启动子多态性与妊娠期糖尿病合并生殖道感染PROM易感性的关联  

Association of Nrf2 gene promoter polymorphism with susceptibility to PROM in gestational diabetes mellitus patients complicated with genital tract infection

作　　者：王海艳[1] 郭艳巍[1] 杨佳琦[2] 刘艳芳 WANG Hai-yan;GUO Yan-wei;YANG Jia-qi;LIU Yan-fang(Affiliated Hospital of Chengde Medical College,Chengde,Hebei 067000,China;不详)

机构地区：[1]承德医学院附属医院产科,河北承德067000 [2]承德医学院预防医学教研室,河北承德067000 [3]承德市妇幼保健院检验科,河北承德067000

出　　处：《中华医院感染学杂志》2023年第6期904-909,共6页Chinese Journal of Nosocomiology

基　　金：承德市科技支撑计划基金资助项目(201801A057)。

摘　　要：目的 探究核因子E2相关因子2(Nrf2)基因启动子多态性与妊娠期糖尿病(GDM)合并生殖道感染患者足月胎膜早破(PROM)易感性的关联。方法 选取2017年1月-2020年6月在承德医学院附属医院定期产检、分娩的GDM产妇175例,分析产妇妊娠期生殖道感染情况和感染病原菌的病原学特点;根据产妇是否发生PROM分为PROM组46例和非PROM组129例,另选取同期于医院正常分娩的健康产妇105名为对照组,聚合酶链反应(PCR)检测Nrf2基因启动子-653G/A、-651G/A和-617C/A位点的多态性。结果 57例(32.57%)GDM产妇发生生殖道感染,检出的89株感染病原菌以革兰阳性菌为主(29.21%)。PROM组、非PROM组和对照组的生殖道感染率比较:PROM组>非PROM组>对照组(P<0.05),新生儿出生体质量比较:PROM组<非PROM组<对照组(P<0.05)。PROM组Nrf2基因启动子-617C/A位点的CC基因型、C等位基因频率均低于非PROM组和对照组(P<0.05)。Logistic回归分析结果显示,生殖道感染、Nrf2基因启动子-617C/A位点CA/AA基因型是足月PROM的危险因素(P<0.05)。结论 GDM产妇生殖道感染发生率较高,感染的病原菌分布具有一定特征性;Nrf2基因启动子-617C/A位点的多态性可能与足月PROM易感性有关,而生殖道感染会进一步促进足月PROM的发生。OBJECTIVE To explore the association of nuclear factor E2-related factor 2(Nrf2) gene promoter polymorphism with the susceptibility to premature rupture of membranes(PROM) in gestational diabetes mellitus(GDM) patients complicated with genital tract infection.METHODS A total of 175 puerpera with GDM who received regular antenatal examinations and gave birth in the Affiliated Hospital of Chengde Medical College from Jan 2017 to Jun 2020 were enrolled in the study. The incidence of gestational genital tract infection and etiological characteristics of pathogens were observed. The enrolled puerpera were divided into the PROM group with 46 cases and the non-PROM group with 129 cases according to the status of PROM. Meanwhile, 105 healthy puerpera who had normal delivery were chosen as the control group. The polymorphisms at-653G/A,-651G/A and-617C/A loci of Nrf2 gene promoter were detected by polymerase chain reaction(PCR). RESULTS Totally 57(32.57%) GDM puerpera had genital tract infection. The gram-positive bacteria(29.21%) were dominant among the 89 strains of pathogens. The incidence of genital tract infection, from high to low, was as the following: the PROM group > the non-PROM group > the control group(P<0.05). The body weight of neonates, from low to high, was as the following: the PROM group < the non-PROM group < the control group(P<0.05). The frequencies of CC genotype and allele C at-617C/A locus of Nrf2 gene promoter were significantly lower in the PROM group than in the non-PROM group and the control group(P<0.05). Logistic regression analysis showed that the genital tract infection and CA/AA genotype at-617C/A locus of Nrf2 gene promoter were the risk factors for the full-term PROM(P<0.05).CONCLUSION The incidence of genital tract infection is high among the puerpera with GDM. The distribution of pathogens shows certain characteristics. The polymorphism at-617C/A locus of Nrf2 gene promoter may be associated with the susceptibility to full-term PROM, and the genital tract infection may further promote

关 键 词：妊娠期糖尿病 生殖道感染 足月胎膜早破 核因子E2相关因子2 基因多态性 

分 类 号：R714.255[医药卫生—妇产科学]