Th1/Th2平衡及HLA-DQA1基因多态性与血液透析导管性感染的相关性

Correlation of Th1/Th2 Balance and HLA-DQA1 Gene Polymorphism with Hemodialysis Catheter-Related Infections

目的:探讨Th1/Th2平衡及人白细胞抗原DQA1(HLA-DQA1)基因多态性与血液透析导管性感染的相关性。方法:选取2020年1月至2024年1月在我院治疗的血液透析导管性感染患者48例作为观察组,同时选取同期血液透析无导管性感染患者260例作为对照组,比较两组Th1、Th2细胞及因子、以及HLA-DQA1基因多态性差异。结果:观察组Th1、Th2、TNF-α、TGF-1、IL-4和IL-6分别为(43.35±9.10)%、(3.10±0.92)%、(46.22±8.87)pg/mL、(50.05±13.36)pg/mL、(1.03±0.35)pg/mL和(40.05±11.65)pg/mL,高于对照组(P<0.05),而Th1/Th2为(14.01±2.20),低于对照组(P<0.05)。观察组和对照组HLA-DQA1基因型差异有统计学意义(P<0.05)。观察组死亡患者TNF-α、IL-4、IL-6分别为(58.07±2.65)pg/mL、(1.22±0.21)pg/mL和(46.67±9.96)ng/L,高于存活患者(P<0.05)。观察组存活和死亡患者HLA-DQA1基因多态性比较差异无统计学意义(P>0.05)。结论:血液透析导管性感染患者Th1、Th2细胞及相关因子水平升高,发生感染和未发生患者HLA-DQA1基因型有所差异,其中TNF-α、IL-4、IL-6与预后有关。

Objective:To explore the correlation between Th1/Th2 balance,human leukocyte antigen DQA1(HLA-DQA1)gene polymorphism,and catheter-related infections during hemodialysis.Methods:Forty-eight patients with hemodialysis catheter-related infections treated at our hospital from January 2020 to January 2024 were selected as the observation group.Two hundred sixty patients undergoing hemodialysis without catheter-related infections during the same period were selected as the control group.The differences in Th1 cells,Th2 cells,associated cytokines,and HLA-DQA1 gene polymorphisms between the two groups were compared.Results:The Th1,Th2,TNF-α,TGF-1,IL-4,and IL-6 levels in the observation group were(43.35±9.10)%,(3.10±0.92)%,(46.22±8.87)pg/mL,(50.05±13.36)pg/mL,(1.03±0.35)pg/mL,and(40.05±11.65)pg/mL,respectively,higher than those in the control group(P<0.05),while Th1/Th2 levels were(14.01±2.20),lower than those in the control group(P<0.05).There was a statisti-cally significant difference in HLA-DQA1 genotype between the observation group and the control group(P<0.05).The TNF-α,IL-4,and IL-6 of the observation group's deceased patients were(58.07±2.65)pg/mL,(1.22±0.21)pg/mL,and(46.67±9.96)ng/L,respectively,higher than those of the surviving pa-tients(P<0.05).There was no statistically significant difference in HLA-DQA1 gene polymorphism between surviving and deceased patients in the observation group(P>0.05).Conclusion:Patients with hemodialysis catheter-related infections exhibit elevated levels of Th1 cells,Th2 cells,and associated factors.There are differences in HLA-DQA1 genotypes between patients with and without infections,with TNF-α,IL-4,and IL-6 levels associated with prognosis.