慢性鼻窦炎患者FCER2基因多态性与鼻用糖皮质激素疗效的相关性研究  

The correlation between FCER2 gene polymorphism and the efficacy of inhaled corticosteroids in patients with chronic rhinosinusitis

作　　者：刘双喜[1] 车娜[1] 金玲[1] 王扬 范锴 赖菊 余少卿[1] LIU Shuangxi;CHE Na;JIN Ling;WANG Yang;FAN Kai;LAI Ju;YU Shaoqing(Department of Otorhinolaryngology Head and Neck Surgery,Tongji Hospital Affiliated to Tongji University,Shanghai,200065,China)

机构地区：[1]同济大学附属同济医院耳鼻咽喉头颈外科,上海200065

出　　处：《临床耳鼻咽喉头颈外科杂志》2023年第11期856-863,共8页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：上海市自然科学基金项目(No:23ZR1458000);上海市卫生健康委员会、上海市中医药管理局上海市综合医院中西医结合专项(No:ZHYY-ZXYJHZX-202118)。

摘　　要：目的:探讨慢性鼻窦炎(chronic rhinosinusitis,CRS)患者FCER2(2206A>G)基因多态性与吸入糖皮质激素(inhaled corticosteroids,ICS)治疗疗效的相关性。方法:208例CRS患者均接受功能性内镜鼻窦手术(functional endoscopic sinus surgery,FESS),术后使用ICS,并应用DNA提取、PCR扩增、基因测序观察FCER2(2206A>G)基因多态性,计算等位基因频率。比较不同基因型CRS术后半年VAS评分,鼻内镜Lund-Kennedy评分及CT影像Lund-Mackay评分变化的差异,并对不同CRS亚群(鼻窦炎伴鼻息肉与不伴鼻息肉,嗜酸性鼻窦炎与非嗜酸性鼻窦炎)的多态频度进行分析。结果:CRS患者存在FCER2(2206A>G)基因多态现象,表型包括AA、AG和GG3种基因型,分布频率分别为68例(32.7%)、116例(55.8%)、24例(11.5%)。术前各基因型的CRS患者的年龄、VAS评分、鼻内镜Lund-Kennedy评分及CT影像Lund-Mackay评分差异无统计学意义,经过术后半年治疗,AA基因型的VAS评分变化值为(5.74±1.10),鼻内镜Lund-Kennedy评分变化值为(5.92±1.14),CT影像Lund-Mackay评分变化值为(13.26±4.26),比AG型(4.37±0.86、5.37±1.24、10.82±3.77)、GG基因型(4.26±0.80、5.18±1.56、10.10±3.53)均高,差异有统计学意义(P<0.05),AG与GG2种基因型间差异无统计学意义(P>0.05)。其中嗜酸粒细胞型鼻窦炎与非嗜酸粒细胞型鼻窦炎比较,GG基因型与AG、AA基因的差异更大(P<0.01)。结论:CRS患者FCER2(2206A>G)基因存在基因多态性,且与CRS术后的病情恢复、个体激素敏感性有关,并存在亚群差异性。Objective:To investigate the correlation between FCER2(2206A>G)gene polymorphism and the efficacy of inhaled corticosteroids(ICS)in patients with chronic rhinosinusitis(CRS).Methods:A total of 208 CRS patients were routinely treated with functional endonasal sinus surgery and postoperative ICS.DNA extraction,PCR amplification and gene sequencing were performed to observe the FCER2(2206A>G)gene polymorphism and calculate the allele frequency.The visual analog scale(VAS)score,Lund-Kennedy score,and computed tomography(CT)Lund-Mackay score were determined 6 months after surgery among patients with different genotypes.Moreover,the polymorphism frequency was compared among different subgroups(chronic rhinosinusitis with nasal polyps versus chronic rhinosinusitis without nasal polyps,eosinophilic chronic rhinosinusitis versus non-eosinophilic chronic rhinosinusitis).Results:There were FCER2(2206A>G)gene polymorphism in patients with CRS,and the phenotypes included 3 genotypes,AA,AG and GG,with distribution frequencies of 68(32.7%),116(55.8%)and 24(11.5%)cases,respectively.No significant differences were found in age,VAS score,nasal endoscopic Lund-Kennedy score and CT imaging Lund-Mackay score among patients with CRS of each genotype before surgery.In patients with the AA genotype,the changes in VAS score(5.74±1.10),Lund Kennedy score(5.92±1.14),and CT imaging Lund-Mackay score(13.26±4.26)were significantly higher than in patients with the AG(4.37±0.86,5.37±1.24,10.82±3.77)and GG(4.26±0.80,5.18±1.56,10.10±3.53)genotype(P<0.05).However,there were no marked difference between patients with the AG genotype and those with the GG genotype(P>0.05).Compared with patients with non-eosinophilic sinusitis,Among them,the differences between the GG genotype and AG/AA genes were more significant in eosinophilic sinusitis compared to non-eosinophilic sinusitis(P<0.01).Conclusion:The FCER2(2206A>G)gene in patients with CRS has genetic polymorphism and is associated with the recovery of CRS patients after surgery,individual c

关 键 词：慢性鼻窦炎 FCER2基因 基因多态性 吸入糖皮质激素 

分 类 号：R765.2[医药卫生—耳鼻咽喉科]