TNF-α基因多态性与外科腹部手术后腹腔真菌感染的关系

TNF-α gene polymorphism of abdominal surgery patients with postoperative abdominal fungal infection

目的探讨肿瘤坏死因子α(TNF-α)基因多态性与外科腹部手术后腹腔真菌感染的关系。方法选择2017年6月-2020年6月达州职业技术学院附属医院普外科进行手术并在术后发生腹腔真菌感染患者62例为研究组,选择同期医院普外科进行手术但术后未发生腹腔感染患者80例为对照组。选择TNF-α基因rs1800629、rs1799964位点进行研究,采用限制性片段长度多态性聚合酶链反应(PCR-RFLP)检测其基因分型,比较两组基因型分布情况。结果研究组TNF-α基因rs1800629G/A位点AA基因型频率、A等位基因频率(35.48%、50.00%)高于对照组,G等位基因频率(50.00%)低于对照组(P<0.05);两组TNF-α基因rs1800629G/A位点GG基因型、AG基因型及TNF-α基因rs1799964 G/A位点GG、AG、AA基因型及G/A等位基因频率分布比较,无统计学差异。TNF-α基因rs1800629G/A位点在隐性模型、纯合模型和加性模型下,腹腔真菌感染风险显著增加(OR=1.335、2.341、2.185);TNF-α基因rs1800629G/A位点携带AA基因型患者胃肠功能障碍评分、负压、死亡人数(2.25±0.45分、18.34±2.30 mmHg、9/22)高于AG/GG型患者(P<0.05);两组重症监护病房(ICU)住院时间、机械通气时间比较,无统计学差异。结论 TNF-α基因rs1800629位点AA基因型、A等位基因频率增加显著增加本地区外周重症患者腹腔真菌感染易感性,但与rs1799964位点无关。

OBJECTIVE To explore the tumor necrosis factor-α(TNF-α) gene polymorphism of the abdominal surgery patients with postoperative abdominal fungal infection. METHODS A total of 62 patients who underwent surgery in general surgery department of the Affiliated Hospital of Dazhou Polytechnic from Jun 2017 to Jun 2020 and had postoperative abdominal infection were recruited as the study group, meanwhile, 80 patients who underwent surgery in general surgery department but did not have postoperative abdominal infection were chosen as the control group. The rs1800629 and rs1799964 loci of TNF-α gene were studied, the genotypes were detected by using polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP), and the genotypes were compared between the two groups. RESULTS The frequencies of rs1800629 G/A locus AA genotype and allele A of the study group were respectively 35.48% and 50.00%, significantly higher than those of the control group, the frequency of allele G of the study group was 50.00%,significantly lower than that of the control group(P<0.05). There were no significant differences in frequencies of rs1800629 G/A locus GG genotype, AG genotype of TNF-αgene, rs1799964 G/A locus GG genotype, AG genotype, AA genotype of TNF-α gene and G/A allele between the two groups. The risk of abdominal fungal infection was significantly increased when the TNF-α gene rs1800629 G/A locus under the recessive model, homozygous model and plus risk model(OR=1.335,2.341,2.185). The gastrointestinal dysfunction score, negative pressure and death toll of the patients carrying with AA genotype at rs1800629 G/A locus of TNF-α gene were significantly higher than those of the patients carrying with AG/GG genotype(P<0.05). There were no significant differences in the length of intensive care unit(ICU) stay and mechanical ventilation duration between the two groups. CONCLUSION The increase of frequencies of AA genotype at rs1800629 locus of TNF-α gene and allele A may remarkably increase the susceptibility to the abdominal fungal infection, which is not associated with the rs1799964 locus.