5-羟色胺转运体基因多态性与AEOPD短期激素干预疗效的关系

Relationship between serotonin transporter gene polymorphism and short-term hormone intervention in acute exacerbation of chronic obstructive pulmonary disease

目的观察5-羟色胺转运体(5-HTT)基因多态性与慢性阻塞性肺疾病急性加重期(A EC O PD)短期激素干预疗效的关系.方法采用随机平行对照方法纳入2017年1月至2018年1月于苏州市立医院呼吸科收治的68例A EC O PD患者为研究对象,开展前瞻性研究.所有患者均接受短期激素干预,采用聚合酶链反应(PCR)技术检测SERT基因多态性,并以实时荧光定量聚合酶链反应(RT-PCR)行5-HTT基因mRNA表达检测.观察并统计患者短期预后,并分析其与5-HTT基因多态性的关系.结果 68例AECOPD患者均接受为期3个月的激素治疗后治愈31例(45.59%),显效20例(29.41%),有效8例(11.76%),均归入疾病控制组.无效9例(13.24%),归入疾病未控制组.疾病控制组S/S基因型频率与S等位基因频率显著高于疾病未控制组(χ^2=3.989、5.165,P值均<0.05),L等位基因频率显著低于疾病未控制组(χ^2=5.165,P=0.023);疾病控制组10/10、12/10、12/12基因型频率与10、12等位基因频率较疾病未控制组差异无统计学意义(χ^2=0.149、0.004、0.512、0.007、0.007,P值均>0.05);疾病控制组5-羟色胺转运体基因启动子区多态性mRNA表达显著低于疾病未控制组(t=2.249,P=0.027),5-羟色胺转运体基因第二内含子多态性mRNA表达较疾病未控制组差异无统计学意义(t=1.835,P=0.071).结论 5-H T T基因多态性影响A EC O PD短期激素干预疗效,临床应引起重视.

Objective To observe the relationship between 5-serotonin transporter ( 5-HTT) gene polymorphism and short-term hormone intervention in patients with acute exacerbation of chronic obstructive pulmonary disease ( AECOPD ). Methods Sixty-eight AECOPD patients admitted to department of respiratory medicine ,Suzhou Municipal Hospital from January 2017 to January 2018 were studied by randomized parallel control method .All patients received short-term hormone intervention , polymerase chain reaction ( PCR ) technique was used to detect the polymorphism of SERT gene ,and the 5-HTT gene mRNA expression was detected by real-time fluorescence quantitative polymerase chain reaction ( RT-PCR ). The short-term prognosis of patients was observed and statistically analyzed , and the relationship between 5-HTT gene polymorphism and its prognosis was analyzed .Results In 68 cases of AECOPD patients ,31 cases (45 .59%) were cured after 3 months of hormone therapy ,20 cases ( 29 .41%) were markedly effective ,8 cases (11 .76%) were effective ,and all were included in the disease control group .Nine cases (13 .24%) were ineffective .The frequency of S/S genotype and S allele in the disease control group was significantly higher than that of in the uncontrolled disease group (χ^2 =3 .989 ,5 .165 ,both P <0 .05),and the frequency of L allele was significantly lower than that of in the uncontrolled disease group (χ^2 =5 .165 , P =0 .023).The frequencies of genotype 10/10 ,12/10 and 12/12 and the frequencies of alleles 10 and 12 in the disease control group were not significantly different from those in the disease control group (χ^2 = 0 .149 ,0 .004 ,0 .512 ,0 .007 ,0 .007 ,all P > 0 .05).The expression of 5-HTTLPR mRNA in the disease control group was significantly lower than that of in the uncontrolled disease group ( t = 2 .249 , P = 0 .027),and the expression of 5-HTTVNTR mRNA was not statistically significant compared with that of the uncontrolled disease group ( t =1 .835 , P =0 .071).Conclusions The polymorphism of 5-HTT gene affects the efficacy of short-term hormone intervention in AECOPD .