E-选择素基因多态性和Ghrelin/Obestatin与NLR及PA与冠心病合并肺部感染的关联  

Association of E-selectin gene polymorphism,Ghrelin/Obestatin,NLR and PA with pulmonary infection in patients with coronary heart disease

作　　者：肖杰 刘小艳 徐智虎 武欣迎 余春俊 XIAO Jie;LIU Xiao-yan;XU Zhi-hu;WU Xin-ying;YU Chun-jun(Wuhan Yaxin General Hospital,Wuhan,Hubei 430022,China;不详)

机构地区：[1]武汉亚心总医院心内科,湖北武汉430022 [2]武汉市第四医院心血管内科,湖北武汉430072 [3]武汉亚心总医院心脏中心,湖北武汉430022

出　　处：《中华医院感染学杂志》2023年第12期1809-1813,共5页Chinese Journal of Nosocomiology

基　　金：湖北省卫建委面上基金资助项目(WJ2019041)。

摘　　要：目的 分析冠心病合并肺部感染患者E-选择素基因多态性、胃饥饿素(Ghrelin)/肥胖抑制素(Obestatin)、中性粒细胞淋巴细胞计数比值(NLR)、前白蛋白(PA)。方法 前瞻性将2018年1月-2022年9月武汉亚心总医院收治的冠心病合并肺部感染患者403例纳入感染组,冠心病未合并肺部感染患者416例纳入未感染组。分析两组临床资料、E-选择素第二外显子+G98T和第四外显子+A561C的基因多态性、血液指标及冠脉损伤程度,通过Pesrson相关性分析法分析血液指标与冠脉损伤程度的相关性。结果 感染组舒张压(DBP)、收缩压(SBP)高于未感染组(P<0.05);两组E-选择素第二外显子+G98T和第四外显子+A561C基因多态性比较,TT型、CC型未检测到,感染组G98T GG型、A561C AC型频率更低,G98T GT型、A561C AA型频率更高(P<0.05);感染组血清E-选择素、NLR水平、Gensini积分高于未感染组(P<0.05),血清Ghrelin/Obestatin、PA水平低于未感染组(P<0.05);E-选择素、NLR与Gensini积分呈正相关(r=0.808、0.780,P<0.05),PA、Ghrelin/Obestatin与Gensini积分呈负相关(r=-0.615、-0.628,P<0.05)。结论 冠心病合并肺部感染患者E-选择素第二外显子+G98T和第四外显子+A561C的基因型分布存在差异,E-选择素、Ghrelin/Obestatin、NLR、PA表达异常,且与患者冠脉损伤程度密切相关,可能作为冠心病合并肺部感染临床诊治的靶点。OBJECTIVE To analyze the polymorphism of E-selectin second and fourth exon genes and the changes of Ghrelin/Obestatin,neutrophil lymphocyte count ratio(NLR),prealbumin(PA) and their clinical significance in patients with coronary heart disease complicated with pulmonary infection.METHODS Totally 403 patients with coronary heart disease combined with pulmonary infection admitted to Wuhan Asia Heart Hospital from Jan.2018 to Sep.2022 were prospectively included in the infection group,and 416 patients with coronary heart disease without pulmonary infection were included in the non-infection group.The clinical data,gene polymorphism of E-selectin second exon +G98T and fourth exon +A561C,blood indexes and the degree of coronary artery damage were analyzed in the two groups,and the correlation between blood indicators and the degree of coronary artery injury was analyzed by Pesrson correlation analysis.RESULTS The levels of diastolic blood pressure(DBP) and systolic blood pressure(SBP) were higher in the infection group than in the non-infection group(P<0.05).The comparison of gene polymorphisms of E-selectin second exon +G98T and fourth exon +A561C between the two groups showed that TT type and CC type were not detected.The frequencies of G98T GG type and A561C AC type were lower in the infected group,while the frequencies of G98T GT type and A561C AA type were higher in the infected group(P<0.05).Serum levels of E-selectin,whole blood NLR and score of Gensini in the infection group were higher than those in the non-infection group(P<0.05),and serum levels of Ghrelin/Obestatin,PA was lower than those in the non-infection group(P<0.05).E-selectin,NLR were positively correlated with Gensini score(r=0.808,0.780,P<0.05),and PA and Ghrelin/Obestatin were negatively correlated with Gensini score(r=-0.615,-0.628,P<0.05).CONCLUSION There were differences in the genotype distribution of E-selectin second exon +G98T and fourth exon +A561C in patients with coronary heart disease complicated with pulmonary infection,E-selectin,Gh

关 键 词：冠心病 肺部感染 E-选择素 基因型 胃饥饿素 肥胖抑制素 冠脉损伤 相关性 

分 类 号：R563.1[医药卫生—呼吸系统]