汉族人髓样分化蛋白2基因启动子区多态性与严重创伤后并发症易感性的关系

Relationship of Myeloid Differentiation-2 Gene Promoter Polymorphisms with Susceptivity of Complications after Severe Trauma in Chinese Han Population

目的探讨中国汉族人髓样分化蛋白2(MD-2)基因启动子单核苷酸多态性及其与严重创伤患者多器官功能衰竭和脓毒症易感性之间的关系。方法应用限制性片段长度多态性-聚合酶链式反应技术,检测105例严重创伤患者(其中42例并发脓毒症)MD-2基因启动子-1625C/G单核苷酸多态性位点基因型。并对所有患者进行多器官功能障碍综合征(MODS)评分。结果-1625G等位基因携带者MODS评分显著高于C等位基因携带者(显性遗传模式P<0.001,隐性遗传模式P>0.05)。携带G等位基因型的创伤患者比C等位基因携带者并发脓毒症的可能性高(OR值为0.477,95%可信区间为0.266-0.855,P<0.05)。携带G等位基因型的创伤患者死亡率显著高于C等位基因携带者(显性遗传模式P<0.05,隐性遗传模式P>0.05)。结论汉族人严重创伤后多器官功能衰竭、脓毒症的易感性与MD-2基因启动子-1625C/G单核苷酸多态性相关。-1625G可能是严重创伤后并发症发生的危险因素。

Objective To investigate the polymorphisms of myeloid differentiation-2 （MD-2） gene promoters , and to explore whether such polymorphisms are associated with the susceptibility to multiple organ dysfunction syndrome （MODS） and sepsis in Chinese Han population. Methods Using polymerase chain reaction-restriction fragment length polymorphism method, the authors detected the single nucleotide polymorphisms of the promoter region of MD-2 gene at position - 1625C/G in 105 severe trauma patients （42 with sepsis ）. The organ function was scored. Results The frequency of CC genotype in MD-2 gene promoter region at position -1625 was 0.5 （21/42） in septic patients and 0.7 （44/63 ） in non-septic patients. The frequency of CG genotype was 0.38 （ 16/42 ） in septic patients and 0.27 （ 17/63 ） in non-septic patients. The frequency of GG genotype was 0. 12 （5/42） in septic patients and 0.03 （2/63） in non-septic patients. The MODS scores in trauma patients carrying G allele at position - 1625 were significantly higher than those carrying C allele （P 〈 0. 001 for dominant effect, and P 〉 0.05 for recessive effect）. Moreover, trauma patients carrying G allele appeared to have higher risk of sepsis comparing to those carrying C allele （ OR 0.477, 95 % CI 0. 266-0. 855, P 〈 0.05）. Sepsis morbidity was significantly different between subjects with C and G alleles （ P 〈 0.05 for dominant effect, P 〉 0.05 for recessive effect）. Conclusions The polymorphisms of the promoter region of MD-2 gene at position - 1625C/G is correlated with MODS and sepsis after severe trauma in Chinese Han population. The people with - 1625G allele in the promoter region of MD-2 gene may be a risk factor of severe complications.