哮喘患儿β2-AR基因多态性与其肺功能改善效果的关系研究

Study on the relationship between β2-AR gene polymorphism and the improving effect of pulmonary function in children with asthma

目的分析哮喘患儿肺功能改善效果与β2肾上腺素能受体(β2-AR)基因多态性的关系,为改善哮喘患儿临床疗效提供参考依据。方法选取该院2019年1-12月收治的140例哮喘患儿作为病例组,另选取同时期健康儿童140例作为对照组,通过TaqMan-PCR法测定受试儿童β2-AR基因的Arg16Gly位点基因多态性。病例组给予沙美特罗替卡松干粉剂治疗3个月,比较2组受试儿童β2-AR基因分型及等位基因频率,并比较病例组不同基因分型患儿肺功能、临床疗效。结果病例组AA型比例显著低于对照组,GG型比例显著高于对照组,等位基因A频率显著低于对照组,差异均有统计学意义(P<0.05)。治疗3个月后,疗效满意组AA型比例显著高于疗效差组,GG型比例显著低于疗效差组,等位基因A频率显著高于疗效差组,差异均有统计学意义(P<0.05)。AA型、AG型患儿第1秒用力呼气容积(FEV1)、FEV1/用力肺活量(FVC)、最大呼气流量(PEF)均显著高于治疗前和GG型,AA型患儿FEV1、FEV1/FVC、PEF均显著高于AG型,差异均有统计学意义(P<0.05)。多元logistic回归分析结果显示,年龄、AA型为哮喘患儿沙美特罗替卡松干粉剂疗效的保护因素(P<0.05);GG型、变应性鼻炎、缓解期停药为哮喘患儿沙美特罗替卡松干粉剂疗效的危险因素(P<0.05)。结论β2-AR基因的Arg16Gly位点可能与哮喘发病存在相关性,该位点变异可能造成患儿肺功能改善效果降低。

Objective To analyze the relationship between the improving effect of pulmonary function and β2 adrenergic receptor(β2-AR)gene polymorphism in children with asthma,and to provide reference for improving the clinical efficacy of children with asthma.Methods A total of 140 asthmatic children admitted to the hospital from January to December 2019 were selected as the case group,and 140 healthy children at the same time were selected as the control group.The Arg16Gly locus gene polymorphism of β2-AR gene in the tested children was determined by TaqMan-PCR.The case group was treated with salmeterol/fluticasone dry powder for 3 months.The β2-AR genotyping and allele frequency of the two groups of children were compared,and the pulmonary function and clinical efficacy of the children with different genotyping in the case group were compared.Results The proportion of AA type in the case group was significantly lower than that in the control group,the proportion of GG type was significantly higher than that in the control group,and the allele A frequency was significantly lower than that in the control group,the differences were statistically significant(P<0.05).After 3 months of treatment,the proportion of AA type in satisfactory efficacy group was significantly higher than that in poor efficacy group,the proportion of GG type was significantly lower than that in poor efficacy group,and the allele A frequency was significantly higher than that in poor efficacy group,the differences were statistically significant(P<0.05).The forced expiratory volume in one second(FEV1),FEV1/forced vital capacity(FVC)and peak expiratory flow(PEF)of AA type and AG type children were significantly higher than those of pre-treatment and GG type children,FEV1,FEV1/FVC and PEF of AA type children were significantly higher than those of AG type children,and the differences were statistically significant(P<0.05).Multivariate logistic regression analysis showed those age and AA type were protective factors for the efficacy of salmeterol/fluticasone dry powder in asthmatic children(P<0.05),while GG type,allergic rhinitis and withdrawal in remission period were risk factors for the efficacy of salmeterol/fluticasone dry powder in asthmatic children(P<0.05).Conclusion The Arg16Gly locus of β2-AR gene may be correlated with asthma,and the variation of this locus may reduce the effect of improving pulmonary function in children.