CAJ | 학술논문

目的探讨人群中IL-8基因启动子区-251基因多态性与严重创伤患者脓毒症发生率的相关性. 方法采用前瞻性队列研究方法,选取296例严重创伤患者,根据其临床表现和血培养结果判定其有无发生脓毒症,并用Marshall方法进行MODS评分.利用聚合酶链反应-限制性片段长度多态性(polymerase chain reaction-restriction fragment length polymorphism,PCR-RFLP)方法对IL-8基因启动子区-251多态性位点进行基因分型检测.用ELISA测定血浆IL-8水平. 结果创伤患者中IL-8/-251位点基因型分布符合哈-温平衡(P＞0.05).携带IL-8/-251 TT、TA和AA基因型的创伤患者脓毒症的发生率分别为58.1％、49.6％和25.0％.多元回归分析显示,患者携带A等位基因的数量与脓毒症发生呈负相关[比值比(odds ratio,OR)=0.637,95％可信区间(confidence interval,CI) (0.421,0.963),P＜0.05].携带A等位基因的创伤患者MODS评分显著小于其他两种基因型携带者(P＜0.05).三种基因型携带者血浆IL-8水平差异有统计学意义(P＜0.01),A等位基因与IL-8表达水平降低相关(P＜0.01). 结论 IL-8-251T/A多态性位点与创伤患者脓毒症的发生相关,AA基因型是创伤脓毒症的保护性基因型.
목적 탐토인군중IL-8기인계동자구-251기인다태성여엄중창상환자농독증발생솔적상관성. 방법 채용전첨성대렬연구방법,선취296례엄중창상환자,근거기림상표현화혈배양결과판정기유무발생농독증,병용Marshall방법진행MODS평분.이용취합매련반응-한제성편단장도다태성(polymerase chain reaction-restriction fragment length polymorphism,PCR-RFLP)방법대IL-8기인계동자구-251다태성위점진행기인분형검측.용ELISA측정혈장IL-8수평. 결과 창상환자중IL-8/-251위점기인형분포부합합-온평형(P＞0.05).휴대IL-8/-251 TT、TA화AA기인형적창상환자농독증적발생솔분별위58.1％、49.6％화25.0％.다원회귀분석현시,환자휴대A등위기인적수량여농독증발생정부상관[비치비(odds ratio,OR)=0.637,95％가신구간(confidence interval,CI) (0.421,0.963),P＜0.05].휴대A등위기인적창상환자MODS평분현저소우기타량충기인형휴대자(P＜0.05).삼충기인형휴대자혈장IL-8수평차이유통계학의의(P＜0.01),A등위기인여IL-8표체수평강저상관(P＜0.01). 결론 IL-8-251T/A다태성위점여창상환자농독증적발생상관,AA기인형시창상농독증적보호성기인형.
Objective To assess the clinical relevance of polymorphisms at position-251 in the promoter region of IL-8 gene and the incidence of sepsis in patients with severe trauma.Methods A total of 296 patients with severe trauma were included in the prospective cohort study.Incidence of sepsis was decided on the basis of the clinical manifestations and blood culture results.Muhiple organ dysfunction score (MODS) was performed using Marshall' s standard.IL-8/-251 gene polymorphisms were genotyped using restriction fragment length polymorphism polymerase chain reaction (PCR-RFLP).IL-8 plasma level was determined using ELISA method.Results Genotype frequency at IL-8/-251 locus in trauma patients was in accord with Hardy-Weinberg equilibrium (P ＞ 0.05).Sepsis incidence in trauma patients with TT,TA,and AA genotypes at IL-8/-251 locus was 58.1％,49.6％,and 25.0％ respectively.Multiple regression analysis showed inverse correlation between sepsis incidence and quantity of A alleles [OR =0.637,95％ CI (0.421,0.963),P ＜ 0.05].Carriers of AA genotype presented lower MODS score than those of other two genotypes (P ＜ 0.05).IL-8 plasma level presented significant difference among carriers of the three genotypes (P ＜ 0.01) and A alleles were associated with the down-regulation of IL-8 (P ＜ 0.01).Conclusion IL-8/-251T/A polymorphisms are implicated in the development of posttraumatic sepsis and AA genotype is protective against posttraumatic sepsis.