维生素D受体基因多态性与重症瓣膜病术后肺部感染易感性及预后的关联  

Association of susceptibility to postoperative pulmonary infection and prognosis with polymorphisms of vitamin D receptor gene in severe valve heart disease patients

作　　者：周家旺[1] 彭冉[2] 胡振东[1] 郑月月[3] 王奇 王鹏[1] ZHOU Jia-wang;PENG Ran;HU Zhen-dong;ZHENG Yue-yue;WANG Qi;WANG Peng(The First Affiliated Hospital of Nanyang Medical College,Nanyang,Henan 473058,China)

机构地区：[1]南阳医学高等专科学校第一附属医院心脏外科,河南南阳473058 [2]南阳医学高等专科学校第一附属医院心脏外科监护室,河南南阳473058 [3]南阳医学高等专科学校第一附属医院内分泌科,河南南阳473058

出　　处：《中华医院感染学杂志》2023年第13期1986-1990,共5页Chinese Journal of Nosocomiology

基　　金：河南省科研基金资助项目(G202013412)。

摘　　要：目的探讨维生素D受体(VDR)基因多态性与重症瓣膜病术后肺部感染易感性及预后的关联。方法选取2018年5月-2021年5月南阳医学高等专科学校第一附属医院行瓣膜置换术后并发肺部感染的重症瓣膜病患者82例为研究组;另选取同期行瓣膜置换术后未并发肺部感染患者36例为对照组,研究组患者根据术后住院期间生存情况分为存活组69例和死亡组13例。收集所有患者临床资料;采集外周静脉血并采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)法检测VDR基因Fok1、TaqI和BsmI位点基因多态性。结果82例术后并发肺部感染患者共培养分离病原菌89株,以革兰阴性菌株为主(75.28%,67/89)。VDR基因Fokl基因型(TT/TC/CC)和等位基因(T、C)频率在研究组和对照组间均有统计学差异(P<0.05);TaqI基因型(CC/CT/TT)和等位基因(C、T)频率,BsmI基因型(GG/GA/AA)和等位基因(G、A)频率在研究组和对照组间均无统计学差异。82例术后并发肺部感染患者中,VDR基因Fokl、TaqI和BsmI基因型和等位基因频率在术后存活组和死亡组患者间均无统计学差异。结论VDR基因Fokl基因多态性与重症瓣膜病术后肺部感染易感性密切相关,携带C等位基因增加术后肺部感染风险;VDR基因Fok1、TaqI和BsmI位点基因多态性与术后临床转归无明显关系。OBJECTIVE To explore the association of susceptibility to postoperative pulmonary infection and prognosis with polymorphisms of vitamin D receptor(VDR)gene in patients with severe valve heart disease patients.METHODS A total of 82 patients with severe valve heart disease who underwent valve replacement in the First Affiliated Hospital of Nanyang Medical College from May 2018 to May 2021 were assigned as the study group,meanwhile,36 patients who underwent valve replacement but were not complicated with pulmonary infection were chosen as the control group.The patients of the study group were divided into the survival group with 69 cases and the death group with 13 cases according to the postoperative survival status during hospital stay.The clinical data were collected from all of the patients,the peripheral venous blood specimens were collected,and the gene polymorphisms at Fokl,Taql and BsmI loci of the VDR gene were detected by polymerase chain reaction-restrictionfragment-length polymorphism(PCR-RFLP)assay.RESULTS Totally 89 strains of pathogens were isolated from the 82 patients complicated with pulmonary infection,among which gram-negative bacteria(75.28%,67/89)were dominant.There were significant differences in the frequencies of Fokl genotypes(TT/TC/CC)and alleles(T,C)of VDR gene between the study group and the control group(P<0.05).There were no significant differences in the frequencies of TaqI genotypes(CC/CT/TT),alleles(C,T),BsmI genotypes(GG/GA/AA)and alleles(G,A)between the study group and the control group.Among the 82 patients who were complicated with postoperative pulmonary infection,there were no significant differences in the frequencies of Fokl,Taql,Bsml genotypes and alleles of VDR gene between the survival group and the death group.CONCLUSION The Fokl gene polymorphism of VDR gene is closely associated with the susceptibility to the postoperative pulmonary infection in the patients with severe valve heart disease,and the C allele may increase the risk of postoperative pulmonary infection.The

关 键 词：重症瓣膜病 瓣膜置换术 术后感染 肺部感染 维生素D受体 基因多态性 

分 类 号：R654.2[医药卫生—外科学]