MBL基因多态性与多发性骨髓瘤患者化疗期间感染的关联

Correlation between MBL gene polymorphisms and infection in multiple myeloma patients during chemotherapy

目的探究甘露糖结合凝集素(MBL)基因多态性与多发性骨髓瘤(MM)患者化疗期间感染并发症的关系。方法选取2019年6月-2020年12月在河南省南阳市第二人民医院接受化疗治疗的MM患者84例,分析化疗期间患者感染情况、感染病原菌分布,PCR技术检测患者MBL基因多态性,酶联免疫吸附法检测血浆MBL水平。结果84例患者中26例化疗期间发生感染,感染率为30.95%;感染部位以呼吸系统为主(65.38%);26例感染患者共检出病原菌41株,其中革兰阴性菌22株(53.66%),革兰阳性菌15株(36.59%),真菌4株(9.76%);感染组患者的肾功能不全占比高于未感染组,血清白蛋白和血浆MBL水平低于未感染组(P<0.05);Hardy-Weinberg平衡检验显示,两组患者MBL基因rs1800450、rs11003125、rs7095891位点基因型分布均符合Hardy-Weinberg规律(P>0.05);两组患者rs1800450、rs7095891位点基因型和等位基因频率比较,差异有统计学意义(P<0.05)。结论MBL基因多态性及其血浆水平与MM患者化疗期间感染并发症的发生相关,临床可通过检测患者MBL基因多态性、血浆MBL水平以评估化疗期间感染的发生风险。

OBJECTIVE To explore the relationship between mannose-binding lectin(MBL)gene polymorphisms and complication of infection in multiple myeloma(MM)patients during chemotherapy.METHODS Totally 84 MM patients who received chemotherapy in Nanyang Second People′s Hospital from Jun 2019 to Dec 2020 were enrolled in the study.The incidence of infection and distribution of pathogens were observed during the chemotherapy,the MBL gene polymorphisms were detected by PCR,and the plasma MBL level was detected by enzyme-linked immunosorbent assay.RESULTS Of the 84 patients,26 had infection during the chemotherapy,with the infection rate 30.95%.The patients who had respiratory system infection accounted for 65.38%.Totally 41 strains of pathogens were isolated from the 26 patients with infection,22(53.66%)of which were gram-negative bacteria,15(36.59%)were gram-positive bacteria,and 4(9.76%)were fungi.The percentage of the patients with renal insufficiency was significantly higher in the infection group than in the no infection group,the levels of serum albumin and plasma MBL of the infection group were significantly lower than those of the no infection group(P<0.05).Hardy-Weinberg balance test showed that the distribution of genotypes at rs1800450,rs11003125 and rs7095891 loci of MBL gene conformed to the Hardy-Weinberg rule(P>0.05);there were significant differences in the frequencies of genotypes and alleles at rs1800450 and rs7095891 loci between the two groups of patients(P<0.05).CONCLUSION The MBL gene polymorphisms are associated with the complication of infection in the MM patients during the chemotherapy.The MBL gene polymorphisms and plasma MBL level may facilitate the assessment of risk for infection during the chemotherapy.