内皮细胞蛋白C受体基因多态性与脓毒症易感性的关联  

Association of polymorphisms of endothelial protein C receptor gene with susceptibility to sepsis

作　　者：魏巍 陈森[2] 胡荍[3] 刘杰 王福珍[4] WEI Wei;CHEN Sen;HU Qiao;LIU Jie;WAN GFu-zhen(The First Clinical College Hubei University of Medicine,Shiyan,Hubei 442000,China;不详)

机构地区：[1]湖北医药学院第一临床学院,湖北十堰442000 [2]湖北医药学院临床技能培训中心,湖北十堰442000 [3]湖北医药学院附属太和医院感染管理科,湖北十堰442000 [4]湖北医药学院附属太和医院重症医学科,湖北十堰442000

出　　处：《中华医院感染学杂志》2023年第9期1319-1322,共4页Chinese Journal of Nosocomiology

基　　金：湖北省卫生健康委青年人才项目(WJ2021F030)。

摘　　要：目的探究内皮细胞蛋白C受体(EPCR)基因多态性与脓毒症易感性的关联,为临床防治脓毒症提供参考。方法选择2019年1月-2021年12月湖北医药学院附属太和医院收治的90例脓毒症患者为研究组,同期63名健康体检者为对照组,分析脓毒症患者感染病原菌分布,实时荧光定量聚合酶链式反应(PCR)检测EPCR基因rs2069948、rs867186位点基因型,酶联免疫吸附法(ELISA)检测血浆可溶性EPCR(sEPCR)水平。结果90例脓毒症患者共检出病原菌85株,其中革兰阳性菌39株占45.88%,革兰阴性菌45株占52.94%,真菌1株占1.18%;脓毒症组EPCR基因rs2069948位点TT基因型、rs867186位点GG基因型占比高于对照组(P<0.05),sEPCR水平(102.13±18.52)ng/ml高于对照组(P<0.05);28 d后脓毒症患者死亡组EPCR基因rs2069948位点TT基因型、rs867186位点GG基因型占比高于生存组(P<0.05),sEPCR水平(110.67±12.59)ng/ml高于生存组(P<0.05)。结论脓毒症患者EPCR基因rs2069948、rs867186位点基因发生突变,EPCR基因多态性与sEPCR水平影响患者预后。OBJECTIVE To explore the association of polymorphisms of endothelial protein C receptor(EPCR)gene with susceptibility to sepsis so as to provide guidance for clinical prevention and treatment of sepsis.METHODS A total of 90 patients with sepsis who were treated in Taihe Hospital Affiliated to Hubei University of Medicine from Jan 2019 to Dec 2021 were assigned as the study group,meanwhile,63 people who received physical examination were chosen as the control group.The distribution of pathogens isolated from the sepsis patients was observed,the genotypes at rs2069948 and rs867186 loci of EPCR gene were detected by real-time fluorescent quantitative polymerase chain reaction(PCR),and the plasma soluble EPCR(sEPCR)was detected by means of enzyme-linked immunosorbent assay(ELISA).RESULTS Totally 85 strains of pathogens were isolated from the 90 patients with sepsis,39(45.88%)of which were gram-positive bacteria,45(52.94%)were gram-negative bacteria,and 1(1.18%)was fungus.The proportions of TT genotype at rs2069948 locus and GG genotype at rs867186 locus of EPCR gene were higher in the sepsis group than in the control group(P<0.05),the sEPCR level of the sepsis group was(102.13±18.52)ng/ml,higher than that of the control group(P<0.05).Among the patients with sepsis,the proportions of TT genotype at rs2069948 locus and GG genotype at rs867186 locus of EPCR gene were higher in the death group than in the survival group(P<0.05),the sEPCR level of the death group was(110.67±12.59)ng/ml,higher than that of the survival group(P<0.05).CONCLUSION There are mutations at rs2069948 and rs867186 loci of EPCR gene in the sepsis patients.The EPCR gene polymorphism and sEPCR level may affect the prognosis of the patients.

关 键 词：脓毒症 内皮细胞蛋白C受体 基因多态性 易感性 

分 类 号：R631.2[医药卫生—外科学]