TNF-α基因多态性与心脏瓣膜置换术后肺部感染的相关性  

Association of TNF-αGene Polymorphisms with Pulmonary Infection After Heart Valve Replacement

作　　者：顾鑫童 李凯[2] 周庆[2] GU Xintong(Medical School of Nanjing University,Jiangsu Nanjing 210093,China)

机构地区：[1]南京大学医学院,江苏南京210093 [2]南京大学医学院附属鼓楼医院,江苏南京210009

出　　处：《河北医学》2024年第12期2023-2028,共6页Hebei Medicine

基　　金：江苏省科技厅科技计划项目,(编号:DL20211992)。

摘　　要：目的:探讨心脏瓣膜置换(HVR)术后肺部感染与TNF-α基因多态性的相关性。方法:回顾性选取2020年1月至2023年12月南京鼓楼医院心脏瓣膜置换术后(HVR)术后患者80例,依据术后肺部感染情况分为有肺部感染组(30例)、无肺部感染组(50例)两组。结果:肺部感染组患者30例共检出病原菌43株,主要为革兰阴性菌,占62.79%,其中大肠埃希菌占20.93%;其次为革兰阳性菌,占25.58%,其中金黄色葡萄球菌占13.95%;最后为真菌,占11.63%,其中白假丝酵母菌占9.30%。有肺部感染组患者的年龄、高脂血症、糖尿病、脑梗死比例均高于无肺部感染组(P<0.05),术中出血量多于无肺部感染组(P<0.05),呼吸机使用时间、体外循环时间、ICU住院时间均长于无肺部感染组(P<0.05)。有肺部感染组患者的左室射血分数、TNF-α基因rs1800629位点的基因分型GG比例、等位基因频率G比例均低于无肺部感染组,GA、AA比例、A比例均高于无肺部感染组(P<0.05)。术后肺部感染的影响因素包括ICU住院时间、体外循环时间、TNF-α基因rs1800629位点AA(P<0.05)。结论:HVR术后肺部感染与TNF-α基因多态性有显著的相关性,后者是前者的易感因素。Objective:To investigate the correlation between lung infection and tumor necrosis factor-alpha(TNF-α)gene polymorphism after heart valve replacement(HVR)surgery.Methods:A total of 80 patients with HVR in Nanjing Drum Tower Hospital from January 2020 to December 2023 were retrospectively selected,and they were divided into lung infection group(30 cases)and non-lung infection group(50 cases)according to the presence or absence of postoperative lung infection.Results:A total of 43 strains of pathogenic bacteria were detected in 30 patients with pulmonary infection,mainly gram-negative bacteria(62.79%),with Escherichia coli(20.93%).Followed by Gram-positive bacteria(25.58%),with Staphylococcus aureus(13.95%).Finally,fungi accounted for 11.63%,with Candida alba(9.30%).The lung infection group had significantly higher the proportion of age,hyperlipidemia,diabetes and cerebral infarction,significantly more the amount of intraoperative blood loss,and significantly longer the duration of ventilator use,cardiopulmonary bypass and ICU stay compared to the non-lung infection group(all P<0.05).The lung infection group presented significantly lower the proportion of the left ventricular ejection fraction,GG genotype frequency of TNF-αgene rs1800629,and G allele frequency and significantly higher the proportion of GA,AA and A relative to the non-lung infection group(all P<0.05).The influencing factors of postoperative pulmonary infection included ICU stay time,extracorporeal circulation time,TNF-αgene rs1800629 site AA(P<0.05).Conclusion:There is a significant correlation between lung infection after HVR and TNF-αgene polymorphism,and the latter is a predisposing factor for the former.

关 键 词：心脏瓣膜置换术 肺部感染 病原菌 TNF-Α基因多态性 相关性 

分 类 号：R563.1[医药卫生—呼吸系统] R654.2[医药卫生—内科学]