PI3K/AKT通路基因单核苷酸多态性与VAP易感性及预后的关联

Relationship of single nucleotide polymorphisms of PI3K/AKT pathway genes with VAP susceptibility and prognosis

目的分析磷脂酰肌醇3-激酶(PI3K/AKT)通路基因单核苷酸多态性(SNP)与呼吸机相关性肺炎(VAP)易感性、预后的关系。方法选取2018年1月-2020年10月惠州市中心人民医院收治的89例VAP患者(VAP组)及同期行机械通气治疗但未发生VAP患者92例(非VAP组),依据28 d预后将VAP患者分为死亡组、存活组,采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)方法检测其PI3K基因、AKT基因多态性,采用Logistic回归法分析不同基因型与VAP易感性及预后的关系。结果VAP组PI3K rs3729679基因型AA与GA、等位基因A频率低于非VAP组,而rs7651265基因型GG与GA、等位基因G频率,rs9838117基因型GT、GG、等位基因G频率均高于非VAP组(P<0.05);VAP组AKT rs33933140基因型GG与GA、等位基因G频率低于非VAP组,rs11880261基因型TT与CT、等位基因T频率,rs1130233基因型CC与CT、等位基因C频率均高于非VAP组(P<0.05);PI3K rs3729679等位基因A、AKT rs33933140等位基因G为VAP的保护因素,PI3K rs7651265等位基因G、rs9838117等位基因G、AKT rs11880261等位基因T为VAP的危险因素(P<0.05);PI3K rs3729679等位基因A、AKT rs33933140等位基因G为VAP患者死亡的保护因素,AKT rs11880261等位基因T为VAP死亡的危险因素(P<0.05)。结论PI3K/AKT通路SNP与VAP易感性及其预后有一定关系,有可能成为VAP预后的新分子指标。

OBJECTIVE To analyze the relationship of single nucleotide polymorphisms of PI3 K/AKT pathway genes with VAP susceptibility and prognosis.METHODS Total of 89 patients with VAP(VAP group)and 92 patients without VAP(non-VAP group)admitted to Huizhou Central People′s Hospital between Jan 2018 and Oct 2020 were enrolled in this study.Patients in the VAP group were subdivided into the dead group and survival group according to the prognosis within 28 days.The polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP)method was used to detect PI3 K gene and AKT gene polymorphisms.Multivariate Logistic regression analysis was conducted to analyze the relationship of different genotypes with susceptibility to VAP and prognosis.RESULTS The frequencies of genotype AA,genotype GA and allele A of PI3 K rs3729679 in the VAP group were significantly lower than those in the non-VAP group,while the frequencies of genotype GG,genotype GA and allele G of rs7651265,genotype GT,genotype GG and allele G of rs9838117 were significantly higher than those in the non-VAP group(P<0.05).The frequencies of genotype GG,genotype GA and allele G of AKT rs33933140 were significantly lower than those in the non-VAP group,while the frequencies of genotype TT,genotype CT and allele T of rs11880261,genotype CC,genotype CT and allele C of rs1130233 were significantly higher than those in the non-VAP group(P<0.05).Allele A of PI3 K rs3729679 and allele G of AKT rs33933140 were protective factors for VAP,while genotype GG and allele G of PI3 K rs7651265,allele G of rs9838117,and allele T of AKT rs11880261 were risk factors for VAP(P<0.05).Allele A of PI3 K rs3729679 and allele G of AKT rs33933140 were protective factors for death of patients with VAP,and allele T of AKT rs11880261 was a risk factor(P<0.05).CONCLUSION There is a certain relationship between SNP of PI3 K/AKT signaling pathway and susceptibility to VAP and prognosis,which suggests that it may be a new molecular indicator for prognosis of VAP.