急性胰腺炎患者脂代谢相关基因APOA5和APOC3多态性及其并发感染性胰腺坏死的影响因素  

Polymorphisms APOA5 and APOC3 genes related to lipid metabolism in patients with acute pancreatitis and the factors influencing their complications with infectious pancreatic necrosis

作　　者：郑娜[1] 牛淑娟[1] 王美玲[1] 郭佳丽 付雷[1] ZHENG Na;NIU Shu-juan;WANG Mei-ling;GUO Jia-li;FU Lei(Shengjing Hospital Affiliated to China Medical University,Shenyang,Liaoning 110000,China)

机构地区：[1]中国医科大学附属盛京医院急诊科,辽宁沈阳110000

出　　处：《中华医院感染学杂志》2023年第12期1838-1842,共5页Chinese Journal of Nosocomiology

基　　金：辽宁省科研基金资助项目(2020H02114)。

摘　　要：目的探讨急性胰腺炎(AP)患者脂代谢相关基因APOA5、APOC3多态性及其并发感染性胰腺坏死(IPN)的影响因素。方法选择中国医科大学附属盛京医院2018年10月-2021年10月收治的AP患者为研究对象,根据是否合并IPN分别纳入IPN组(n=35)和非IPN组(n=97);采用聚合酶链式扩增反应(PCR)扩增APOA5基因rs619054、APOC3基因rs138326449位点目的序列,反应结束后在凝胶成像分析仪中观察分型结果。通过电子病历系统获取患者性别、年龄、AP程度、发病原因、禁食时间和静脉营养时间等临床资料,以多因素Logistic回归分析AP患者并发IPN的影响因素。结果IPN组和非IPN组APOA5基因rs619054位点、APOC3基因rs138326449位点各基因型频率分布与理论分布差异无统计学意义,表明符合哈迪-温伯格平衡;IPN组APOA5基因rs619054位点携带AA基因型频率、A等位基因频率高于非IPN组(P<0.05);多因素Logistic回归分析结果显示,AP程度、禁食时间、静脉营养时间、携带APOA5基因rs619054位点AA基因型均为AP并发IPN的影响因素(P<0.05)。结论携带APOA5基因rs619054位点AA基因型显著增加AP患者IPN风险。OBJECTIVE To investigate the polymorphisms of APOA5 and APOC3 gene related to lipid metabolism in patients with acute pancreatitis(AP)and the factors affecting their complications with infectious pancreatic necrosis(IPN).METHODS Patients with AP admitted to the emergency department of the Shengjing Hospital Affiliated to China Medical University between Oct.2018 to Oct.2021 were selected as the study subjects and were included in the IPN group(n=35)and the non-IPN group(n=97)according to whether they were combined with IPN or not.Polymerase chain amplification(PCR)was used to amplify the target sequences of APOA5 gene rs619054 and APOC3 gene rs138326449,and the typing results were observed in the gel imaging analyzer after reaction.Clinical data such as gender,age,severity of AP,pathogenesis,duration of fasting and duration of intravenous nutrition were obtained through the electronic medical record system,and multivariate Logistic regression was used to analyze the risk factors of AP patients complicated with IPN.RESULTS There was no significant difference in the frequency distribution of APOA5 gene rs619054 and APOC3 gene rs138326449 between IPN and non-IPN groups,indicating compliance with Hardy-Weinberg equilibrium.The frequencies of AA genotype and A allele at Rs619054 of APOA5 gene in IPN group were higher than those in non-IPN group(P<0.05).Multivariate Logistic regression analysis showed that AP severity,duration of fasting,duration of intravenous nutrition,and APOA5 gene rs619054 AA genotype were the influencing factors of AP complicated with IPN(P<0.05).CONCLUSION Carrying APOA5 gene rs619054 locus AA genotype significantly increased the risk of IPN in AP patients.

关 键 词：急性胰腺炎 感染性胰腺坏死 脂代谢相关基因 载脂蛋白A5 载脂蛋白C3 基因多态性 

分 类 号：R576[医药卫生—消化系统]