PAI-1与F5基因多态性与重症医学科患者静脉血栓风险发生的相关性研究

The Correlation Analysis between PAI-1 and F5 Gene Polymorphism and The Risk of Venous Thromboembolism in Patients with Intensive Care Unit

目的探索PAI-1与F5基因多态性检测在重症医学科(ICU)患者静脉血栓风险评估中的应用价值。方法选取我院ICU 2019年6月~2020年2月行静脉血栓风险基因检测并经彩色多普勒超声血流成像确诊有不同程度下肢深静脉血栓形成的患者90例,作为VTE组。同期选取排除静脉血栓高风险及经彩色多普勒超声血流成像诊断下肢静脉血栓为阴性的90例患者作为对照组。采用数字荧光染色原位杂交检测法对PAI-1基因4G/5G与F5基因G/A多态性进行检测。结果 PAI-1基因4G/5G的3种基因型在VTE组和对照组的分布频率分别为:4G4G型(41.11%,24.44%)、4G5G型(47.78%,55.56%)和5G5G型(11.11%,20.00%)。其VTE组患者基因型分布频率在与对照组患者基因型分布比较,差异有统计学意义(P<0.05)。F5基因在VTE组和对照组的分布频率分别为GG型(100%,98.89%) GA型(0%,1.11%)只有对照组1例为GA基因型,其余179例全为GG基因型。为通过非条件logistic回归模型分析,对PAI-1 5G5G基因型患者相比,4G4G基因型患者静脉血栓发生风险升高4.7倍(95%CI=1.926~11.517),4G5G基因型患者静脉血栓发生风险升高2.4倍(95%CI=1.051~5.518),静脉血栓发生率差异具有统计学意义(P<0.05)。结论 PAI-1基因4G/5G多态性对ICU患者静脉血栓风险形成的预测具有重要的临床意义。

OBJECTIVE To explore the application value of PAI-1 and F5 gene polymorphism detection in the risk of venous thromboembolism assessment in ICU patients. METHODS From June 2019 to February 2020,a total of 90 patients who were tested for venous thrombosis risk gene and diagnosed by color doppler ultrasound blood flow imaging with different degrees of deep venous thromboembolism in our hospital,were selected retrospectively as the VTE group.In the same period,90 patients who excluded high risk of venous thromboembolism and were negative for venous thromboembolism by color doppler ultrasound flow imaging were selected as the control group.Fluorescence staining in situ hybridization was used to detect the PAI-1 gene 4 G/5 G and F5 gene G/A polymorphism.RESULTS The distribution frequencies of the three genotypes of PAI-1 gene 4 G/5 G in the VTE group and the control group were4 G4 G genotype( 41. 11%,24. 44%),4 G5 G genotype( 47. 78%,55. 56%) and 5 G5 G genotype( 11. 11%,20. 00%),respectively. The frequency of the genotype distribution of patients in the VTE group was statistically different from that of the control group( P<0.05).The distribution frequency of F5 gene in VTE group and control group were GG genotype( 100%,98.89%) and GA genotype( 0%,1.11%).Only one case of control group was GA genotype,and the remaining 179 cases were all GG genotype.Analyzed by unconditional logistic regression model,compared with patients with PAI-1 5 G5 G genotype,the risk of venous thrombosis in patients with 4 G4 G genotype was increased 4.7 times( 95% CI = 1. 926-11. 517),and the risk of venous thrombosis in patients with 4 G5 G genotype was increased 2. 4 times( 95% CI = 1. 051-5. 518). There are statistically significant differences in the incidence of venous thromboembolism( P < 0. 05).CONCLUSION PAI-1 gene 4 G/5 G polymorphism has important clinical significance for predicting the risk of venous thrombosis to ICU patients.