表面活性蛋白D及白细胞介素-10基因多态性与老年2型糖尿病并发肺部感染的关联

Etiology of pulmonary infection and its relationship with polymorphisms of surfactant protein D and interleukin-10 genes in elderly patients with type 2 diabetes mellitus

目的 分析老年2型糖尿病(T2DM)并发肺部感染病原学特点及表面活性蛋白D(SP-D)、白细胞介素-10(IL-10)基因多态性。方法 选择2018年1月-2020年9月宁夏医科大学附属银川市中医医院收治的老年T2DM并发肺部感染患者42例为感染组,同期收治的老年T2DM未并发肺部感染患者70例为未感染组。分析感染患者病原菌分布,采用限制性片段长度多态性聚合酶链反应(PCR-RELP)检测两组患者SP-D基因Met11Thr (rs721917 T/C)位点、IL-10基因-1082 (rs1800896 G/A)位点基因型。结果 42例感染组患者共分离出58株病原菌,其中革兰阴性菌38株占65.52%,革兰阳性菌19株占32.76%,真菌1株占1.72%。两组患者年龄、T2DM病程比较,差异有统计学意义(P<0.05)。两组SP-D基因Met11Thr (rs721917 T/C)位点基因型频率分布差异有统计学意义(P<0.05),感染组C等位基因频率高于未感染组(P<0.05),两组IL-10基因-1082 (rs1800896 G/A)位点基因型频率分布无统计学差异,但感染组G等位基因频率高于未感染组(P<0.05)。结论老年T2DM并发肺部感染病原菌以革兰阴性菌为主,SP-D、IL-10基因多态性与感染关系密切。

OBJECTIVE To analyze the etiological characteristics of pulmonary infection and its relationship with polymorphisms of surfactant protein D(SP-D) and interleukin-10(IL-10) genes in elderly patients with type 2 diabetes mellitus(T2 DM). METHODS A total of 42 elderly T2 DM patients complicated with and pulmonary infection who were admitted to Yinchuan Hospital of Traditional Chinese Medicine Affiliated to Ningxia Medical University between January 2018 and September 2020 were enrolled in the study. The other 70 elderly T2 DM patients without pulmonary infection during the same period were enrolled as the non-infection group. The distribution of pathogens in infection patients was analyzed. The genotypes of SP-D gene at Met11 Thr(rs721917 T/C) locus and IL-10 gene at-1082(rs1800896 G/A) locus in both groups were detected by polymerase chain reaction-restriction fragment length polymorphism(PCR-RELP). RESULTS From the 42 elderly patients with T2 DM and pulmonary infection, 58 strains of pathogens were isolated, including 38 strains of Gram-negative bacteria(65.52%), 19 strains of Gram-positive bacteria(32.76%) and 1 strain of fungus(1.72%). There were significant differences in age and course of T2 DM between the two groups(P<0.05). The difference in the frequency of SP-D genotype between the two groups was significant(P<0.05). The frequency of C allele in the infection group was significantly higher than that in the non-infection group(P<0.05). The difference in frequency of IL-10 genotype between the two groups was not significant(P>0.05). The frequency of G allele in the infection group was significantly higher than that in the non-infection group(P<0.05). CONCLUSION Gram-negative bacteria is the main pathogen of pulmonary infection in elderly patients with T2 DM. The polymorphisms of SP-D and IL-10 genes are closely related to infection.