肺部感染的病原菌分布特征及白细胞介素-27基因多态性的研究  

Study on the distribution characteristics of pathogens and polymorphisms of IL-27 gene in pulmonary infection

作　　者：李强 张婷 Li Qiang;Zhang Ting(Department of Laboratory Medicine,Xinyang Xingang Hospital,Xinyang,Henan 464100,China)

机构地区：[1]信阳信钢医院检验科,河南信阳464100

出　　处：《感染、炎症、修复》2024年第4期301-306,共6页Infection Inflammation Repair

摘　　要：目的:分析肺部感染患者的病原菌分布特征,研究白细胞介素-27(IL-27)基因多态性对肺部感染患者临床结局的影响。方法:选择2022年1月至2024年1月因肺部感染入院治疗的98例患者为研究对象,根据患者临床结局,将住院期间死亡、发生器官功能障碍、并发败血症等的患者纳入不良组(n=23),其余纳入良好组(n=75)。所有患者均行病原菌分离鉴定,实时聚合酶链式反应-限制性片段长度多态性(PCR-RFLP)法检测IL-27基因多态性,多因素Logistics回归方法分析肺部感染患者临床结局的影响因素。结果:不良组与良好组肝肾功能不全、侵入性操作、合并基础病、使用抗菌药时间和抗菌药种类等比较,差异有统计学意义(P<0.05)。革兰氏阴性菌为主要感染致病菌,以铜绿假单胞菌(18.75%)和肺炎克雷伯菌(16.96%)为主;革兰氏阳性菌以肺炎链球菌为主。良好组和不良组IL-27基因rs181206T/C位点和rs17855750T/G位点各基因频率比较,差异无统计学意义(P>0.05);不良组与良好组rs153109A/G位点的基因型和基因频率比较,差异有统计学意义(P<0.05),良好组以rs153109A/G位点AG基因型为主,不良组以AA基因型为主;不良组rs153109A/G位点等位基因A的基因频率(73.91%)明显高于良好组(54.00%,P<0.05)。合并基础病、侵入性操作和使用抗菌药时间≥15 d是肺部感染患者出现不良临床结局的独立危险因素(P<0.05)。结论:肺部感染以革兰氏阴性菌为主要病原菌,IL-27基因rs153109A/G位点多态性与肺部感染患者临床结局有关,但合并基础病、侵入性操作和使用抗菌药时间≥15d是肺部感染患者出现不良临床结局的独立危险因素。Objective:To analyze distribution characteristics of pathogens in patients with pulmonary infection,and study the effects of gene polymorphisms of interleukin-27(IL-27)on clinical outcomes of patients with pulmonary infection.Methods:A total of 98 patients from January 2022 to January 2024 admitted to the hospital due to pulmonary infection were enrolled as the research objects.According to clinical outcomes,patients with death,organ dysfunction and sepsis during hospitalization were included in the adverse group(n=23),and the rest were included in the good group(n=75).The isolation and identification of pathogens were conducted in all patients.The polymorphisms of IL-27 gene were detected by real-time polymerase chain reaction-restricted fragment length polymorphism(PCR-RFLP).The influencing factors of clinical outcomes in patients with pulmonary infection were analyzed by Logistics multivariate regression analysis.Results:There were significant differences in liver-kidney dysfunction,invasive operation,combined underlying diseases,time and types of antibiotics between good group and adverse group(P<0.05).Gram-negative bacteria were the main pathogens,which were mainly on Pseudomonas aeruginosa(18.75%)and Klebsiella pneumoniae(16.96%).Streptococcus pneumoniae was one of the main Gram-positive bacteria.There was no significant difference in frequencies of IL-27 gene at rs181206T/C and rs17855750T/G locus between good group and adverse group(P>0.05),but there were significant differences in genotypes and gene frequency at rs153109A/G locus(P<0.05).The AG genotype at rs153109A/G locus was dominant in the good group,and AA genotype was dominant in the adverse group.The gene frequency of allele A at rs153109A/G locus in the adverse group(73.91%)was significantly higher than that in good group(54.00%,P<0.05).Combined underlying diseases,invasive operation and duration of antibiotic use≥15 d were independent risk factors of adverse clinical outcomes in patients with pulmonary infection(P<0.05).Conclusions:Gram-negati

关 键 词：肺部感染 病原菌 白细胞介素-27 基因多态性 rs153109A/G位点 rs181206T/C位点 影响因素 

分 类 号：R563.1[医药卫生—呼吸系统]