多耐药相关蛋白1、多耐药相关蛋白2基因多态性与肺结核耐药的临床关系探讨  

Resistance associated protein 1,multidrug resistance associated protein 2 gene polymorphism and drug resistance in pulmonary tuberculosis

作　　者：刘明 张焕[1] 王显雷[1] 谢炯 申旭阳 LIU Ming;ZHANG Huan;WANG Xianlei;XIE Jiong;SHEN Xuyang(Department 3 of Tuberculosis,Hebei Chest Hospital,Shijiazhuang 050000,China)

机构地区：[1]河北省胸科医院结核三科,石家庄050000

出　　处：《传染病信息》2025年第1期26-31,共6页Infectious Disease Information

基　　金：河北省卫生健康委员会资助项目(20220944)。

摘　　要：目的探讨多耐药相关蛋白1(multidrug resistance associated protein 1,MRP1)、多耐药相关蛋白2(multidrug resistance associated protein 2,MRP2)基因多态性与肺结核耐药的临床关系。方法将河北省胸科医院2021年2月至2024年3月收治的243例初诊肺结核患者纳入研究,取外周血提取总脱氧核糖核酸(deoxyribonucleic acid,DNA),检测MRP1(C218T、G2168A、G1666A位点)、MRP2(C24T、C3972T位点)基因多态性。对患者上述基因采用Hardy-Weinberg定律进行遗传平衡检验;检测肺结核耐药情况并分为耐药组(n=52)和敏感组(n=191),比较2组一般资料及MRP1、MRP2基因多态性;Logistic回归分析肺结核耐药的影响因素。结果患者MRP1、MRP2各位点基因多态性均符合Hardy-Weinberg遗传平衡定律(P均>0.05);肺结核耐药发生率为21.40%(52/243),且耐药组MRP1 C218T CC、MRP1 G2168A GA、MRP1 G1666A GG、MRP2 C24T CC基因型占比均高于敏感组(P均<0.05),MRP1 C218T C、MRP1 G2168A A、MRP1 G1666A G、MRP2 C24T C等位基因频率均高于敏感组(P均<0.05);MRP1 C218T CC(OR=2.016,95%CI:1.168~3.800)、MRP1 G2168A GA(OR=2.155,95%CI:1.250~3.717)、MRP1 G1666A GG(OR=2.168,95%CI:1.176~3.997)、MRP2 C24T CC(OR=2.252,95%CI:1.356~3.742)基因型均是肺结核耐药的危险因素(P<0.05)。结论MRP1 C218T CC、MRP1 G2168A GA、MRP1 G1666A GG、MRP2 C24T CC基因型均可增加肺结核耐药的风险。Objective To explore the clinical relationships between polymorphism of multidrug resistance associated protein 1(MRP1)and multidrug resistance associated protein 2(MRP2)gene polymorphism and drug resistance in pulmonary tuberculosis.Methods 243 Two hundred and forty-three newly diagnosed tuberculosis patients admitted to Hebei Chest Hospital from February 2021 to March 2024 were selected.Total deoxyribonucleic acid(DNA)was extracted from peripheral blood mononuclear cells,and MRP1(C218T,G2168A,G1666A locis)and MRP2(C24T,C3972T locis)gene polymorphisms were detected.Hardy-Weinberg’s law was used to perform genetic balance tests on the aforementioned genes in patients.The drug resistance of pulmonary tuberculosis was detected and the patients were divided into resistant group and sensitive group,and the general information and MRP1 and MRP2 gene polymorphisms were compared between the two groups.Logistic regression analysis was used to explore the influencing factors for drug resistance in pulmonary tuberculosis.Results The genetic polymorphisms of MRP1,MRP2 in patients conformed to the Hardy-Weinberg equilibrium law(P>0.05).The incidence of drug resistance in pulmonary tuberculosis was 21.40%(52/243).The proportions of MRP1 C218T CC,MRP1 G2168A GA,MRP1 G1666A GG,and MRP2 C24T CC genotypes in the resistant group were higher than those in the sensitive group(P<0.05),and the allele frequencies of MRP1 C218T C,MRP1 G2168A A,MRP1 G1666A G,and MRP2 C24T C were all higher than those in the sensitive group(P<0.05).The genotypes of MRP1 C218T CC(OR=2.016,95%CI:1.168~3.800),MRP1 G2168A GA(OR=2.155,95%CI:1.250~3.717),MRP1 G1666A GG(OR=2.168,95%CI:1.176~3.997),and MRP2 C24T CC(OR=2.252,95%CI:1.356~3.742)were all risk factors for tuberculosis drug resistance(P<0.05).Conclusion MRP1 C218T CC,MRP1 G2168A GA,MRP1 G1666A GG,and MRP2 C24T CC genotypes can increase the risk of tuberculosis drug resistance.

关 键 词：多耐药相关蛋白1 多耐药相关蛋白2 基因多态性 肺结核 耐药 

分 类 号：R521[医药卫生—内科学]