大麻素受体1基因多态性与脑卒中患者应激性高血糖及导尿管相关尿路感染易感性的关联  

Association between cannabinoid receptor 1 gene polymorphism and stress hyperglycemia,susceptibility to catheter-associated urinary infection in stroke patients

作　　者：高文勇[1] 艾艳萍 吴琼莹 黄华 魏海棠[2] GAO Wen-yong;AI Yan-ping;WU Qiong-ying;HUANG Hua;WEI Hai-tang(Wuhan Hankou Hospital,Wuhan,Hubei 430012,China)

机构地区：[1]武汉市汉口医院神经内科,湖北武汉430012 [2]武汉市汉口医院康复医学科,湖北武汉430012

出　　处：《中华医院感染学杂志》2023年第8期1167-1171,共5页Chinese Journal of Nosocomiology

基　　金：湖北省卫生健康委科技计划项目(WJ2017F042)。

摘　　要：目的探讨脑卒中患者应激性高血糖及导尿管相关尿路感染(CAUTI)易感性与大麻素受体1(CB1R)基因多态性的关系。方法选择武汉市汉口医院神经内科2020年5月-2021年5月因脑卒中住院接受治疗患者为研究对象,选择发生应激性高血糖和未发生应激性高血糖患者各80例,分别纳入应激性高血糖组和非应激性高血糖组。进行聚合酶链式扩增反应扩增CB1R基因rs1049353位点目标序列并通过测序确定分型结果。统计患者性别、年龄、体质量指数、Charlson共病指数评分、脑卒中类型和CAUTI情况。统计患者入院后24 h内空腹血糖(FBG)和血糖不稳定指数(GLI)。统计所有应激性高血糖组入院后7、30 d神经功能缺损评分(NIHSS)和应激性高血糖组30 d预后情况。结果应激性高血糖组CAUTI发生率高于非应激性高血糖组(P<0.05);两组CB1R基因rs1049353位点基因型分布差异有统计学意义(P<0.05);应激性高血糖组CB1R基因rs1049353位点G等位基因和GG基因型频率低于非应激性高血糖组,AA基因型频率高于非应激性高血糖组(P<0.05);应激性高血糖组CB1R基因rs1049353位点携带AA基因型患者CAUTI发生率、入院当天FBG、GLI水平高于携带GG/GA型患者(P<0.05);应激性高血糖组CB1R基因rs1049353位点携带AA型和GG/GA型住院时间、30 d NIHSS评分、30 d存活情况比较差异无统计学意义,AA型7 d NIHSS评分高于GG/GA型(P<0.05)。结论CB1R基因rs1049353位点AA基因型增加脑卒中患者应激性高血糖和CAUTI风险,其机制还需进一步研究。OBJECTIVE To investigate the relationship between the susceptibility of stress hyperglycemia and catheter-associated urinary tract infection(CAUTI)and cannabinoid receptor 1(CB1R)gene polymorphism in stroke patients.METHODS Patients hospitalized for stroke in the neurology department of Hankou Hospital in Wuhan City from May 2020 to May 2021 were enrolled,including 80 patients with stress hyperglycemia in the hyperglycemia group and 80 patients without stress hyperglycemia in the non-stress hyperglycemia group.Polymerase chain amplification assay was used to amplify the target sequence at rs1049353 of the CB1R gene,and the typing results were confirmed by sequencing.The gender,age,body mass index,Charlson comorbidity index score,stroke type and CAUTI were collected in all patients.The fasting blood glucose(FBG)and glycemic instability index(GLI)in the patients within 24 hours after admission were detected.The neurological deficit score(NIHSS)at 7 d and 30 d after admission in all stress hyperglycemia groups and the prognosis of stress hyperglycemia group at 30 days were analyzed.RESULTS The incidence of CAUTI in the stress hyperglycemia group was higher than that in the non-stress hyperglycemia group(P<0.05);the genotype distribution at the rs1049353 locus of the CB1R gene was significantly different between the two groups(P<0.05).In the stress hyperglycemia group,the frequency of AA genotype was higher than that in the non-stress hyperglycemia group(P<0.05).The incidence of CAUTI and the levels of FBG and GLI on the day of admission in patients carrying AA genotype were significantly higher than those carrying GG/GA genotype(P<0.05).There were no differences in hospitalization time,30 d NIHSS score,and 30 d survival between patients carrying AA type and GG/GA genotype in the stress hyperglycemia group,while 7 d NIHSS score in patients carrying AA genotype was higher than that carrying GG/GA genotype(P<0.05).CONCLUSION The AA genotype at rs1049353 of the CB1R gene significantly increases the risk for stress hyper

关 键 词：大麻素受体1 基因多态性 脑卒中 应激性高血糖 导尿管相关尿路感染 住院时间 

分 类 号：R691.3[医药卫生—泌尿科学]