2型糖尿病肾病患者并发肺部感染表面活性蛋白D基因多态性与影响因素分析

Analysis of surfactant protein D gene polymorphisms and influencing factors in patients with type 2 diabetic nephropathy complicated by pulmonary infection

目的探究分析2型糖尿病肾病患者并发肺部感染表面活性蛋白D(Surfactant protein D,SP-D)基因多态性与影响因素分析。方法选择2015年1月-2018年12月山东省千佛山医院收治的2型糖尿病肾病患者90例,根据是否并发肺部感染分为感染组41组和未感染组49例。采用PCR-限制性片段长度多态性(PCR-RFLP)分析法检测SP-D基因Met11Thr(rs721917T/C)多态性,并检测SP-D水平,并归纳2型糖尿病患者并发肺部感染的影响因素。结果肺部感染组血清SP-D为(23.74±4.16)ng/L高于未感染(P<0.001);肺部感染组rs721917 T/C位点的TT基因型频率为14.63%(6/41)、CT基因型频率为31.71%(13/41)、CC基因型频率为53.66%(22/41)与未感染组比较差异有统计学意义(P<0.05);肺部感染组的rs721917 T/C位点C等位基因频率69.51%(57/82)、T等位基因频率30.49%(25/82)与未感染组比较差异有统计学意义(P<0.05);年龄、糖尿病病程、维持性血液透析、肾功能为失代偿期是2型糖尿病肾病患者并发肺部感染的影响因素(P<0.05)。结论2型糖尿病肾病患者并发肺部感染患者的SP-D水平呈升高趋势,可为肺部感染诊断提供参考,SP-D基因Met11Thr(rs721917 T/C)位点多态性可能与肺炎感染的易感性有关,C基因可能为易感基因,T基因为保护基因;此外特别注意高龄、糖尿病病程长、需要维持性血液透析、肾功能为失代偿期的易感染人群,减少肺部感染的发生率。

OBJECTIVE To investigate and analyze the polymorphisms of surface active protein D gene and its influencing factors in patients with type 2 diabetic nephropathy complicated by pulmonary infection.METHODS Totally 90 patients with type 2 diabetic nephropathy admitted to Qianfoshan hospital of Shandong Province from Jan.2015 to Dec.2018 were selected.They were divided into 41 cases of infection group and 49 cases of non-infection group according to whether they were complicated by pulmonary infection.The SP-D gene Met11 Thr(rs721917 T/C)polymorphism were detected by PCR-restriction fragment length polymorphism(PCR-RFLP)analysis,and the SP-D levels were detected.Factors influencing pulmonary infection in patients with type 2 diabetes were summarized.RESULTS The SP-D in the serum of lung infection group was(23.74±4.16)ng/L,significantly higher than that of the uninfected group(P<0.001).The TT genotype frequency of the rs721917 T/C locus was 14.63%(6/41),the CT genotype frequency was 31.71%(13/41),and the CC genotype frequency in the lung infection group was 53.66%(22/41),significantly different from those of the uninfected group(P<0.05).The rs721917 T/C locus C allele frequency 69.51%(57/82)and T allele frequency 30.49%(25/82)in the lung infection group were significantly different from those in uninfected group(P<0.05).Age,duration of diabetes,maintenance of hemodialysis,and decompensation of renal function were the influencing factors of pulmonary infection in patients with type 2 diabetic nephropathy(P<0.05).CONCLUSION The SP-D level of patients with type 2 diabetic nephropathy complicated by pulmonary infection was increasing,which can provide a reference for the diagnosis of pulmonary infection.The polymorphism of SP-D gene Met11 Thr(rs721917 T/C)might be related to susceptibility to pulmonary infection,the C gene might be a susceptibility gene,and the T genewas a protective gene.In addition,special attention should be paid to susceptible people who were elderly,had a long course of diabetes,required maintenance hemodialysis,and whose kidney function is decompensated,so as to reduce the incidence of lung infection.