NOD2基因多态性与克罗恩病患者肠切除术后腹腔感染易感性的关联

Relationship between NOD2 gene polymorphism and susceptibility to abdominal cavity infection after intestinal resection in Crohn’s disease patients

目的 探讨核苷酸结合寡聚化结构域蛋白2(NOD2)基因多态性与克罗恩病(CD)患者肠切除术后腹腔感染易感性的关系。方法 选择唐山市工人医院普外科2017年1月-2021年1月因CD入院接受肠切除术并在术后发生腹腔感染并发症患者41例为感染组,以倾向性匹配评分法按照1∶1的比例选择同期医院行肠切除术但术后未发生腹腔感染并发症患者41例为非感染组。通过医院电子病历系统调取纳入对象临床资料,入组时抽取外周血采用酶联免疫吸附法检测血清中NOD2通路相关因子NOD2、受体相互作用蛋白2(RIP2)和核因子-κB(NF-κB)水平。采用限制性片段长度多态性聚合酶链反应对NOD2基因R702W位点多态性进行检测。结果感染组血清中NOD2、RIP2、NF-κB水平高于非感染组(P<0.05);感染组与非感染组NOD2基因R702W位点基因型频率分布经检验均符合哈迪-温伯格平衡;感染组患者NOD2基因R702W位点AA基因型、A等位基因频率分别为46.34%、54.88%,均高于非感染组(P<0.05);重度感染组NOD2基因R702W位点AA基因型、A等位基因频率高于轻/中度感染组(P<0.05)。结论 NOD2基因R702W位点多态性与本地区CD患者肠切除术后腹腔感染风险增加有关,其机制还需进一步研究。

OBJECTIVE To investigate the relationship between Nucleotide binding oligomerization domain protein 2(NOD2) gene polymorphisms and the susceptibility to abdominal infection in patients with Crohn′s disease(CD) after enterectomy. METHODS A total of 41 patients who were admitted to the General Surgery Department of Tangshan Workers′ Hospital from Jan 2017 to Jan 2021 due to CD and had abdominal infection complications after the operation were selected as the infection group. Based on the propensity matching scoring method, 41 patients who underwent intestinal resection in the hospital during the same period but did not develop complications of abdominal cavity infection after the operation were selected as the non-infected group according to the ratio of 1∶1. The clinical data of the included subjects were retrieved through the hospital electronic medical record system, and peripheral blood was drawn at the time of enrollment, and the enzyme-linked immunosorbent assay was used to detect the NOD2 pathway related factors NOD2, receptor interacting protein 2(RIP2) and nuclear factors in the serum-κB(Nuclear factor-κB, NF-κB) level. Polymerase chain reaction-restriction fragment length polymorphism was used to detect the R702 W locus polymorphism of NOD2 gene. RESULTS The levels of serum NOD2, RIP2, and NF-κB in the infected group were significantly higher than those in the non-infected group(P<0.05);the frequency distribution of the R702 W locus of NOD2 gene in the infected group and the non-infected group was in line with Kazakhstan Di-Weinberg balance;the AA genotype and A allele frequencies of the NOD2 gene R702 W locus in the infected group were 46.34% and 54.88%, respectively, significantly higher than those in the non-infected group(P<0.05);the frequency of AA genotype and A allele at R702 W locus of NOD2 gene in severe infection group was significantly higher than that in mild/moderate infection group(P<0.05). CONCLUSION The R702 W locus polymorphism of the NOD2 gene was related to the increased risk of abdominal infection after enterectomy in CD patients in this region, and its mechanism needs further study.