IL-27基因多态性与严重外伤后脓毒症患者预后的关联

Association of IL-27 gene polymorphism with prognosis of patients with sepsis after severe trauma

目的 探讨白细胞介素-27(IL-27)基因多态性与严重外伤后脓毒症患者预后的关联。方法 选择安徽医科大学附属六安医院急诊外科2019年5月-2020年5月收治的严重外伤后脓毒症患者50例为脓毒症组,同期医院收治的严重创伤后未发生脓毒症患者60例为对照组。采用SNaPshot技术检测两组患者外周血DNA中IL-27基因-964A>G位点基因型及等位基因分布。检测两组患者血清乳酸、IL-27水平,统计患者入院时急性生理与慢性健康评分(APACHEⅡ)、序贯器官衰竭评分(SOFA)及最终生存情况。结果 脓毒症组IL-27基因-964A>G位点GG基因型、G等位基因频率高于对照组,而AA基因型、A等位基因频率低于对照组(P<0.05);校正性别、年龄、体质量指数、入院时损伤严重程度计分(ISS)评分等混杂因素后,多元Logistic回归分析结果表明,携带IL-27基因-964A>G位点GG基因型、G等位基因是严重创伤后脓毒症的影响因素(P<0.05);携带GG型严重创伤脓毒症患者血清IL-27、血乳酸、APACHEⅡ、SOFA评分均高于携带AA/AG型患者(P<0.05),携带GG型严重创伤脓毒症患者病死率(58.82%)高于AA/AG型患者(P<0.05)。结论 IL-27基因-964A>G位点多个单核苷酸多态性(Single nucleotide polymorphism, SNP)突变显著增加本地区严重创伤患者发生脓毒症的风险,且与不良预后相关,其中G等位基因为易感基因,GG基因为易感基因型。

OBJECTIVE To investigate the relationship between the polymorphism of Interleukin-27(IL-27) gene and the prognosis of sepsis patients after severe trauma. METHODS A total of 50 patients with severe post-traumatic sepsis admitted to the emergency department of Lu′an Hospital affiliated to Anhui Medical University from May 2019 to May 2020 was selected as the sepsis group, and 60 patients who did not develop sepsis after severe trauma admitted to the hospital during the same period were selected as the sepsis group. SNaPshot technology was used to detect the genotype and allele distribution of IL-27 gene-964 A>G locus in the peripheral blood DNA of the two groups of patients. The serum lactic acid and IL-27 levels of the two groups of patients were detected, the acute physiology and chronic health score(APACHE II), sequential organ failure score(SOFA) of patients on admission, and final survival status were counted. RESULTS The frequency of GG genotype and G allele of IL-27 gene-964 A>G locus in the sepsis group was significantly higher than that of the control group, while the frequency of AA genotype and A allele significantly lower than the control group(P<0.05);after adjusting for confounding factors such as gender, age, body mass index, and ISS score at admission, the results of multiple logistic regression analysis showed that the GG gene Type and G alleles of IL-27 gene-964 A>G locus were independent risk factor for sepsis after severe trauma(P<0.05);serum IL-27, blood lactic acid, APACHE II, SOFA scores of severe trauma sepsis patients with type GG were significantly higher than those with AA/AG type(P<0.05), and the fatality rate of the severe trauma sepsis patients(58.82%)with GG type was significantly higher than that of patients with AA/AG type(P<0.05). CONCLUSION The SNP mutation of IL-27 gene-964 A>G locus significantly increased the risk of sepsis in patients with severe trauma in this region, and was associated with poor prognosis. Among which, the G allele was susceptible gene, and GG gene was susceptible genotype.