CYP2C19和CD14基因多态性与急性心肌梗死 PCI术后感染的关联  

Association of CYP2C19 and CD14 gene polymorphisms with postoperative infection in patients with acute myocardial infarction after PCI

作　　者：韩杰 刘燕坤 孙彦彦 HAN Jie;LIU Yan-kun;SUN Yan-yan(Henan Provincial Chest Hospital(Chest Hospital of Zhengzhou University),Zhengzhou,Henan 454950,China;不详)

机构地区：[1]河南省胸科医院(郑州大学附属胸科医院)心血管内科一病区,河南郑州454950 [2]伊宁海关技术中心检验科,新疆伊犁835000

出　　处：《中华医院感染学杂志》2023年第16期2463-2467,共5页Chinese Journal of Nosocomiology

基　　金：河南省科技攻关基金资助项目(202102310036)。

摘　　要：目的 分析细胞色素P450 2C19(CYP2C19)、白细胞分化抗原14(CD14)基因多态性与急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术后医院感染的关联。方法 选取2017年1月-2021年1月河南省胸科医院收治的120例行PCI治疗的AMI患者,根据PCI术后有无发生医院感染分为感染组(n=25)和未感染组(n=95),分析病原菌,分析影响AMI患者PCI术后医院感染的因素;采用聚合酶链反应-限制片段长度多态(PCR-RFLP)法进行CYP2C19、CD14基因多态性分析,采用Logistic回归分析CYP2C19、CD14基因多态性与并发医院感染的关系。结果 25例AMI患者PCI术后医院感染患者共培养出病原菌44株,其中革兰阴性菌33株占75.00%,革兰阳性菌9株占20.45%,真菌2株占4.55%;肌酐、血浆白蛋白为AMI患者PCI术后医院感染的危险因素(P<0.05);感染组CYP2C19基因慢代谢型分布和CD14基因rs2569190位点TT基因频率及T等位基因频率高于未感染组,CC基因频率及C等位基因频率低于未感染组(P<0.05),两组CYP2C19基因纯合子快代谢型、杂合子快代谢型分布比例及CT基因频率差异无统计学意义;CYP2C19基因慢代谢型(OR=1.533)和CD14基因-rs2569190位点T基因型(OR=1.419)与AMI患者PCI术后医院感染有关(P<0.05)。结论 肌酐、血浆白蛋白及CYP2C19基因慢代谢型和CD14基因rs2569190 SNP位点T等位基因会增加AMI患者PCI术后医院感染的危险性。OBJECTIVE To analyze the association of cytochrome P4502C19(CYP2C19)and cluster of differentiation 14(CD14)gene polymorphisms with hospital-acquired infection in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).METHODS A total of 120 patients with AMI who underwent PCI in Henan Chest Hospital from Jan.2017 to Jan.2021 were selected as the study subjects,and were divided into the infection group(n=25)and the non-infection group(n=95)according to the presence or absence of hospital infection after PCI.The distribution of pathogenic bacteria was analyzed,and the risk factors of hospital infection in patients with AMI after PCI were analyzed by logistic regression analysis.CYP2C19 and CD14 gene polymorphisms were analyzed by polymerase chain reaction-restricted fragment length polymorphism(PCR-RFLP),and the relationship between CYP2C19 and CD14 gene polymorphisms and hospital infection in patients with AMI after PCI was evaluated by logistic regression analysis.RESULTS A total of 44 strains of pathogenic bacteria were cultured in 25 patients with hospital infection after PCI,of which 33 strains of gram-negative bacteria accounted for 75.00%,9 strains of gram-positive bacteria accounted for 20.45%,and 2 strains of fungi accounted for 4.55%.Creatinine and plasma albumin were independent risk factors for hospital-acquired infection in patients with AMI after PCI(P<0.05).The distribution of CYP2C19 gene slow metabolism phenotype and frequency of TT gene and T allele of CD14 rs2569190 in the infection group were higher than those in the non-infection group,while the frequency of CC gene and C allele were lower than those in the non-infection group(P0.05).There was no significant difference in the distribution proportions of homozygous and heterozygous CYP2C19 fast metabolism phenotypes and CT gene frequency between the two groups.CYP2C19 gene slow metabolism phenotype(OR=1.533)and T genotype of CD14 rs2569190(OR=1.419)were associated with hospital-acquired infection in patients w

关 键 词：急性心肌梗死 经皮冠状动脉介入治疗 术后感染 医院感染 危险因素 细胞色素P4502C19 白细胞分化抗原14 

分 类 号：R542.22[医药卫生—心血管疾病]