TNF-α基因多态性及缺氧对激素诱导性股骨头坏死的影响分析

Combined effect of TNF-α polymorphisms and hypoxia on steroid-induced osteonecrosis of femoral head

目的探讨肿瘤坏死因子(TNF)-α基因多态性及缺氧对激素诱导性股骨头坏死的影响。方法选取2013年1月-2015年1月期间我院收治的100例激素性股骨头坏死患者作为病例组,同时选取同期我院体检的100例健康人群作为对照组,采用反向点杂交技术检测并比较两组患者的TNF-α基因型,分析影响激素性股骨头坏死相关因素,Logistic回归分析来分析TNF-α的基因多态性和环境因素在激素性股骨头坏死发生中的相互作用。结果病例组患者rs1800629的AA基因型比例(17.0%)较高,对照组比例(5.0%)较低,病例组患者rs1800630的AA基因型比例(33.0%)较高,对照组比例(4.0%)较低,Logistic回归分析显示AA基因型患激素性股骨头坏死的风险更高。病例组患者的有缺氧史的比例(67.0%)明显高于对照组(42.0%)(P<0.05);Logistic回归分析显示,有缺氧史的患者TNF-α的rs1800629为突变基因型均能增加激素性股骨头坏死风险;患者TNF-α的rs1800630为变异基因型并经历了缺氧状态,那么其患激素性股骨头坏死风险更高。结论 TNF-α基因多态性及缺氧显著影响激素诱导性股骨头坏死发生,TNF-α基因多态性及缺氧在激素诱导性股骨头坏死发生过程中可能存在相互作用,在临床诊断和治疗中应加以关注。

Objective To investigate combined effect of TNF-αpolymorphisms and hypoxia on steroid-induced osteonecrosis of femoral head.Methods During January 2013 to January 2015 in our hospital,100 cases of patients with steroid-induced osteonecrosis of femoral headfemoral were selected as the observation group,and 100 healthy people were selected as the control group at the same period in our hospital,to detect and compare TNF-αgenotype of two groups of patients by the reverse dot blot technique,and analyze the impact factors of steroid-induced osteonecrosis of femoral head,and investigate the interaction effect of TNF-αpolymorphisms and hypoxia factor on SONFH by Logistic regression analysis.Results the proportion of AA genotype of rs1800629 of the observation group（17.0%）was significantly higher that of the control group（5.0%）,and the proportion of AA genotype of rs1800630 of the observation group（33.0%）was significantly higher than that of the control group（4.0%）（P〈0.05）,Logistic regression analysis showed that the patients with AA genotype has a higher risk of steroid-induced osteonecrosis of femoral head.The proportion of hypoxia history of patients in the observation group（67.0%）was significantly higher than that of the control group（42.0%）（P〈0.05）;For the person with hypoxic history,GG and AG＋AA genotypes of rs1800629 could increase their risk to suffer SONFH If the patients with the variant genotypes of rs1800630 experienced hypoxia state,then the risk for SONFH increased.Conclusion SONFH was influenced by TNF-αpolymorphisms and hypoxia history.There existed strong interaction between TNF-αpolymorphisms and hypoxia history,and it was worthy to be concerned in diagnosis and treatment.