MMP-9基因C1562位点多态性和血清水平对脑梗死患者压疮感染的影响

Relationship between MMP-9 gene polymorphism in peripheral blood and pressure ulcer infection and disease susceptibility in patients with cerebral infarction

目的 探讨基质金属蛋白酶-9(MMP-9)基因多态性及血清水平与脑梗死住院患者压疮感染易感性及病情严重程度的关系。方法 选择南宁市第八人民医院神经内科2018年3月-2020年3月进行脑梗死治疗的患者作为研究对象,根据住院情况,从中选取发生压疮与未发生压疮患者各90例分别纳入研究组及对照组;采用限制性片段长度多态性聚合酶链反应法扩增MMP-9基因C1562位点目标序列,使用一代测序仪确定分型结果;采用酶联免疫吸附法检测血清MMP-9水平。结果 研究组MMP-9基因C1562位点TT基因型、T等位基因频率(28.89%、48.33%)高于对照组,CC基因型、C等位基因频率(32.22%、51.67%)低于对照组(P<0.05);MMP-9基因C1562位点TT型患者血清MMP-9水平,压疮分期Ⅲ~Ⅳ级比例及Braden量表评分、住院天数均高于CC/CT型患者(P<0.05);多元Logistic回归分析结果表明,住院天数,携带TT基因型、T等位基因是脑梗死患者住院期间发生Ⅲ~Ⅳ级压疮的影响因素(P<0.05)。结论 MMP-9基因C1562位点C/T突变增加本地区脑梗死患者住院期间发生压疮感染的风险,且与疾病严重程度有关,其中TT基因型为易感基因型,值得进行检测。

OBJECTIVE To explore the relationship between the matrix metalloproteinase-9(MMP-9) gene polymorphism and serum level in peripheral blood and the susceptibility to pressure ulcer infection and severity of the disease in hospitalized patients with cerebral infarction. METHODS Patients under cerebral infarction treatment in the Department of Neurology of our hospital from Mar 2018 to Mar 2020 were enrolled as the research subject. According to the hospitalization situation, 90 patients with and without pressure ulcers were divided into the study group and the control group. Restriction fragment length polymorphism polymerase chain reaction assay was used to amplify the target sequence of MMP-9 gene C1562 site, which was determined the typing results by the first generation sequencer. Enzyme-linked immunosorbent assay was used to detect serum MMP-9 levels. RESULTS The frequency of TT genotype and T allele(28.89%, 48.33%) at C1562 site of MMP-9 gene in the study group was significantly higher than that in the control group, while the frequency of CC genotype and C allele(32.22%, 51.67%) was significantly lower than that in the control group(P<0.05). The serum MMP-9 level, the proportion of pressure ulcer stages Ⅲ to Ⅳ, the Braden scale score, and the length of hospital stay in patients carrying TT genotype at C1562 locus of MMP-9 gene were all significantly higher than those in patients carrying CC/CT genotype(P<0.05). Multiple Logistic regression analysis showed that the length of hospitalization, and the TT genotype and T alleles were the risk factors for grade Ⅲ-Ⅳ pressure ulcers in patients with cerebral infarction(P<0.05). CONCLUSION MMP-9 gene C1562 C/T mutation significantly increases the risk of pressure ulcer infection during hospitalization in patients with cerebral infarction in this region, and is related to the severity of the disease. The TT genotype is a susceptible genotype and needs to be tested.