VDRFokl基因多态性及MMP-9、MIP-2、Cys C变化与急性左心衰竭并发肺部感染的关联  

Changes of VDR Fokl gene polymorphism,MMP-9,MIP-2,CysC in acute left heart failure patients complicated with pulmonary infection

作　　者：韦玲 李影 闻明 田永红 严娜 WEI Ling;LI Ying;WEN Ming;TIAN Yong-hong;YAN Na(Tianjin Teda Hospital,Tianjin 300457,China;不详)

机构地区：[1]天津泰达医院急诊科,天津300457 [2]天津泰达医院感染疾病科,天津300457 [3]泰达国际心血管病医院急诊科,天津300457

出　　处：《中华医院感染学杂志》2024年第16期2457-2461,共5页Chinese Journal of Nosocomiology

基　　金：天津市科技计划研究基金资助项目(22JCQNJC01780)。

摘　　要：目的 探究急性左心衰竭(ALHF)并发肺部感染患者维生素D受体(VDR)Fokl基因多态性、基质金属蛋白酶-9(MMP-9)、巨噬细胞炎症蛋白-2(MIP-2)、胱抑素C(Cys C)变化。方法 选取天津泰达医院2022年6月-2023年6月收治的148例ALHF患者,其中并发肺部感染的患者(41例)纳入感染组,未并发肺部感染患者(107例)纳入非感染组;采用限制性片段长度多态性聚合酶链反应检测两组VDR Fokl基因多态性,比较两组血清MMP-9、MIP-2、Cys C水平,三者对ALHF患者肺部感染的预测价值利用受试者工作特征(ROC)曲线进行分析。结果 两组均符合Hardy-Weinburg平衡;感染组VDR Fokl rs2228570位点ff基因型与f等位基因频率高于非感染组,而FF基因型与F等位基因频率低于非感染组(P<0.05);感染组血清MMP-9、MIP-2、Cys C水平高于非感染组(P<0.05);MMP-9、MIP-2、Cys C联合检测诊断ALHF患者并发肺部感染的曲线下面积(AUC)值高于各项单一检测(P<0.05),且联合检测的敏感度为82.93%,特异度为87.85%。结论 MMP-9、MIP-2、Cys C在ALHF患者肺部感染中高表达,且三者联合对其预测价值高;VDR Fokl基因多态性与ALHF患者肺部感染的发病相关。OBJECTIVE To investigate the the changes of polymorphism of vitamin D receptor(VDR)Fokl gene,matrix metalloproteinase-9(MMP-9),macrophage inflammatory protein-2(MIP-2),cystatin C(Cys C)in patients with acute left heart failure(ALHF)and pulmonary infection.METHODS A total of 148 patients with ALHF admitted to Tianjin Teda Hospital from Jun 2022 to Jun 2023 were selected,among which 41 patients with pulmonary infection were included in the infected group,and 1o7 patients without pulmonary infection were included in the non-infected group.Restriction fragment length polymorphism polymerase chain reaction was used to detect VDR Fokl gene polymorphisms in two groups.Serum levels of MMP-9,MIP-2 and Cys C were compared between the two groups,and the predictive value of the three for pulmonary infection in ALHF patients was analyzed by receiver operating characteristic(ROC)curve.RESULTS Both groups were consistent with Hardy-Weinburg equilibrium.The frequency of ff genotype and f allele at VDR Fokl rs2228570 in the infected group was higher than that in the non-infected group,while the frequency of FF genotype and F allele in the infected group was lower than that in the non-infected group(P<0.05).Serum levels of MMP-9,MIP-2 and Cys C in the infected group were higher than those in the non-infected group(P<0.05).The area under the curve(AUC)value of the combined detection of MMP-9,MIP-2 and CysC in the diagnosis of pulmonary infection in ALHF patients was higher than that of the single detection(P<o.05),and the sensitivity and specificity of the combined detection were 82.93%and 87.85%.CONCLUSION MMP-9,MIP-2 and CysC were highly expressed in ALHF patients with pulmonary infection,and the combination of the three had high predictive value.VDR Fokl gene polymorphism was associated with the incidence of pulmonary infection in patients with ALHF.

关 键 词：急性左心衰竭 肺部感染 基质金属蛋白酶-9 巨噬细胞炎症蛋白-2 胱抑素C 维生素D受体Fokl 基因多态性 受试者工作特征曲线 

分 类 号：R563.1[医药卫生—呼吸系统]