CD14基因多态性与婴幼儿肺部感染易感性的关联及交互作用

Relationship and interaction between CD14 gene polymorphism and susceptibility to infectious pneumonia in infants

目的探讨CD14基因多态性与婴幼儿肺部感染易感性的关联及交互作用。方法选择河南省新乡市中心医院儿科2020年1月-2021年1月收治的120例被确诊为婴幼儿肺炎的患儿为病例组,选择同期医院保健室进行体检且结果为健康的婴幼儿60名为对照组。通过电子病历系统调取病例组和对照组婴幼儿临床资料,根据患儿临床症状、肺部体征结合实验室检查结果将病例组患儿分为重症组和非重症组。采用聚合酶链式扩增反应(PCR)检测CD14基因rs2569190、rs5744455位点多态性。结果病例组剖宫产率高于对照组,出生时Apgar评分低于对照组(P<0.05);哈迪-温伯格检验结果显示病例组和对照组CD14基因rs2569190、rs5744455位点基因型分布理论值和实际值比较差异无统计学意义;病例组CD14基因rs2569190位点TT基因型、T等位基因频率高于对照组,CC基因型频率低于对照组(P<0.05);重症组rs2569190位点TT基因型频率、T等位基因频率高于轻症组,CT基因型频率低于轻症组(P<0.05);交互作用分析结果显示,rs2569190多态性×出生方式、rs2569190多态性×出生时Apgar评分和rs2569190多态性×出生方式×出生时Apgar评分3种交互作用模型下模型检验准确度、交叉一致性均较好(P<0.001)。结论CD14基因rs2569190位点TT基因型增加婴幼儿肺炎易感性,其机制还需深入研究。

OBJECTIVE To explore the relationship and interaction between CD14 gene polymorphism and susceptibility to infectious pneumonia in infants and young children.METHODS A total of 120 children diagnosed with infantile pneumonia admitted to the department of Pediatrics of Xinxiang Central Hospital in Henan Province from Jan 2020 to Jan 2021 were recruited in the case group,and 60 healthy infants under physical examination in the Health Room of the hospital during the same period were in the control group.The clinical data of the infants in the case group and the control group were retrieved through the electronic medical record system,and the infants in the case group were divided into the severe group and the non-severe group according to the clinical symptoms,pulmonary signs and laboratory examination results.The polymorphisms of rs2569190 and rs5744455 sites of CD14 gene were detected by polymerase chain amplification reaction(PCR)asaay.RESULTS The cesarean section rate in the case group was significantly higher than that in the control group,while the Apgar score at birth was significantly lower than that in the control group(P<0.05).Hardy-weinberg test showed that there was no significant difference in the theoretical and actual genotype distribution of RS2569190 and RS5744455 sites of CD14 gene between the case group and the control group.The frequency of TT genotype and T allele at rs2569190 of CD14 gene in case group was significantly higher than that in control group,while CC genotype frequency was significantly lower than that in control group(P<0.05).TT genotype frequency and T allele frequency of RS2569190 locus in the severe group were significantly higher than those in the mild group,while CT genotype frequency was significantly lower than that in the mild group(P<0.05).The results of interaction analysis showed that rs2569190 polymorphism×birth mode,RS2569190 polymorphism×birth mode×Apgar score,and RS2569190 polymorphism×birth mode×Apgar score had better model accuracy and cross-consistency(P<0.001).CONCLUSION The TT genotype at the rs2569190 locus of the CD14 gene significantly increases the susceptibility to pneumonia in infants,and the mechanism needs to be further studied.