TNF-α基因多态性在老年肾移植受者感染中的作用  

Impact of TNF-α Gene Polymorphism on Infections in Old Recipients after Renal Transplantation

作　　者：顾新伟[1] 赵明[1] 范礼佩[1] 李民[1] 钱俊[1] 

机构地区：[1]第一军医大学附属珠江医院器官移植科,广东广州510282

出　　处：《中国医师杂志》2004年第3期322-323,共2页Journal of Chinese Physician

摘　　要：目的　探讨肿瘤坏死因子 -α(TNF -α)基因多态性对老年肾移植受者术后感染的影响。方法　采用序列特异引物聚合酶链反应 (PCR -SSP)方法检测 1998-0 1～ 2 0 0 1-0 1间的 87例老年肾移植受者的肿瘤坏死因子 -α启动子区域 -3 0 8位点处的基因多态性 ,并观察其对术后排斥反应、感染发生率和受者、移植物存活率的影响 ,随访时间为 18个月。结果　未发现TNF -α高低产量基因型受者在移植术后排斥反应发生率方面有差异 ;TNF -α低产量基因型受者在随访期内的感染发生率和感染平均发生次数 ( 67 2 %,1 68)均明显高于高产量基因型者 ( 4 1 4%,0 86) ,呈显著性差异 (P =0 0 2 1,0 0 17) ;在首次感染发生的平均时间、各种感染方面两组均无显著性差异 ,但低产量基因型者的病毒感染发生率要高于高产量型者 ;也未发现在肿瘤坏死因子 -α基因型对受者和移植物存活率方面有差异。结论　TNF -α低产量基因型老年受者肾移植术后可能更容易发生感染。检测肿瘤坏死因子Objective To study the influence of tumor necrosis factor-alpha (TNF-α) gene polymorphism on infections in old kidney allograft recipients. Methods The TNF-α genotype in -308 promoter position was determined in 87 old kidney transplant recipients from January 1998 to January 2001 by PCR using sequence -specific primer(PCR-SSP), and then the effects of genotypes on the frequency of rejection and infection, and the survival rate of the patient and graft were observed. Results 58 recipients were low TNF-α production genotype and 29 were high TNF-α production genotype. There were no significant differences in the frequency of rejection, median day of first infection and kinds of infections between the two genotypes. The frequency and times of infections were higher in low TNF-α genotype recipients than those in high TNF-α genotype recipients(67 2% vs 41 4%, P=0 021; 1 68 vs 0 86, P=0 017). The survival rates of the patients and grafts were equal in both the two groups. Conclusion The old recipients with low TNF-α production genotype may be susceptible to infections under routine immunosuppression. It is helpful for old recipients to perform more individual immunosuppression regimens according to TNF-α genotype.

关 键 词：TNF-Α 基因多态性 老年人 肾移植受者 感染 术后并发症 排斥反应 免疫抑制 

分 类 号：R699[医药卫生—泌尿科学]