维生素D受体基因多态性与多发性骨髓瘤化疗后感染的关联  

Relationship between vitamin D receptor gene polymorphism and infection in multiple myeloma patients after chemotherapy

作　　者：陈丽娟 叶璐 张家友 韩少玲 CHEN Li-juan;YE Lu;ZHANG Jia-you;HAN Shao-ling(The Second Affiliated Hospital of Chengdu Medical College,416th Hospital of Nuclear Industry,Chengdu,Sichuan 610051,China)

机构地区：[1]成都医学院第二附属医院/核工业四一六医院血液科,四川成都610051 [2]成都医学院第二附属医院/核工业四一六医院肿瘤科,四川成都610051

出　　处：《中华医院感染学杂志》2023年第17期2665-2668,共4页Chinese Journal of Nosocomiology

基　　金：四川省自然科学基金项目(202065169)。

摘　　要：目的探究维生素D受体(VDR)基因多态性与多发性骨髓瘤(MM)化疗后感染的关联.方法选取2017年5月-2021年5月于成都医学院第二附属医院化疗期间发生医院感染的MM患者30例为感染组,同期未发生医院感染的患者48例为非感染组,分析感染病原菌分布特点,采用限制性片段长度多态性聚合酶链反应(PCR-RFLP)法检测VDR rs7975232、rs1544410位点基因分布情况,多因素Logistic回归分析MM患者化疗后感染的影响因素.结果30例感染患者共检出病原菌46株,以革兰阴性菌为主,占56.52%;感染组VDR基因rs7975232位点C等位基因频率高于非感染组(P<0.05);粒细胞减少(OR=1.533)、低蛋白血症(OR=1.608)是MM患者化疗后感染的独立影响因素(P<0.05).结论MM患者化疗后感染风险较高,且感染病原菌主要为革兰阴性菌,其发生感染可能与VDR基因rs7975232位点基因突变有关,同时粒细胞减少、低蛋白血症是MM患者化疗后感染的影响因素.OBJECTIVE To explore the relationship between vitamin D receptor(VDR)gene polymorphisms and infection in multiple myeloma(MM)patients after chemotherapy.METHODS From May 2017 to May 2021,totally 30 MM patients who had nosocomial infection in the Second Affiliated Hospital of Chengdu Medical College during chemotherapy were assigned as the infection group,meanwhile,48 patients who did not have nosocomial infection were chosen as the non-infection group.The distribution of pathogens was analyzed,the genes at rs7975232 and rs1544410 loci of VDR were detected by polymerase-chain-reaction-restriction-fragment-length polymorphism(PCR-RFLP)assay.Multivariate logistic regression analysis was performed for influencing factors for the infection in the MM patients after chemotherapy.RESULTS Totally 46 strains of pathogens were isolated from the 30 patients with infection,56.52%of which were gram-negative bacteria.The frequency of C allele at rs7975232 locus of VDR gene was higher in the infection group than in the non-infection group(P<0.05).Granulocytopenia(OR=1.533)and hypoproteinemia(OR=1.608)were the independent influencing factors for the infection in the MM patients after chemotherapy(P<0.05).CONCLUSION The MM patients are at high risk of in-fection after chemotherapy.The gram-negative bacteria are dominant among the pathogens causing the infection.The infection may be associated with the gene mutation at rs7975232 locus of VDR.The granulocytopenia and hypoproteinemia are the influencing factors for the infection in the MM patients after chemotherapy.

关 键 词：维生素D受体 多发性骨髓瘤 化疗 感染 影响因素 

分 类 号：R738.1[医药卫生—肿瘤]