TGF-β1基因多态性及IL-8、CRP、GRO-α和U-HBP与脓毒症预后的关联

Association of TGF-β1 gene polymorphisms, IL-8, CRP, GRO-α and U-HBP with prognosis of patients with sepsis

目的 探讨转化生长因子β1(TGF-β1)基因多态性及白细胞介素-8(IL-8)、C-反应蛋白(CRP)、生长趋化因子-α(GRO-α)和尿肝素结合蛋白(U-HBP)与脓毒症预后的关联。方法 选取2014年6月-2020年3月遵义医科大学附属医院就诊的76例脓毒症患者为脓毒症组,选取同期76名体检健康者为对照组,脓毒症组患者根据入院后28 d生存情况,分为生存组42例和死亡组34例。检测外周血TGF-β1基因多态性,比较外周血IL-8、CRP、GRO-α和U-HBP水平,并分析其对脓毒症患者预后的预测价值。结果 脓毒症组IL-8、CRP、GRO-α和U-HBP水平高于对照组(P<0.05);脓毒症组TGF-β1 rs1800471位点CC基因、C等位基因频率低于对照组,CG基因、G等位基因高于对照组(P<0.05);脓毒症患者生存组IL-8、CRP、GRO-α和U-HBP水平低于死亡组(P<0.05);生存组TGF-β1 rs1800471位点CC基因、C等位基因频率高于死亡组,CG基因、G等位基因低于死亡组(P<0.05);受试者工作特征(ROC)曲线分析显示,IL-8、CRP、GRO-α和U-HBP联合预测脓毒症患者预后的曲线下面积为0.912高于IL-8的0.730、CRP的0.770、GRO-α的0.716、U-HBP的0.798(P<0.05)。结论 TGF-β1 rs1800471位点基因与脓毒症的易感性及其预后相关,IL-8、CRP、GRO-α和U-HBP联合预测脓毒症患者预后的预测效能较好。

OBJECTIVE To explore the association between transforming growth factor β1(TGF-β1) gene polymorphism, interleukin-8(IL-8), C-reactive protein(CRP), growth-regulated oncogene-α(GRO-α), urine heparin-binding protein(U-HBP) and prognosis of patients with sepsis. METHODS A total of 76 patients with sepsis who were treated in the Affiliated Hospital of Zunyi Medical University from Jun 2014 to Mar 2020 were assigned as the sepsis group, meanwhile, 76 healthy people who received physical examination were chosen as the control group. The patients of the sepsis group were divided into the survival group with 42 cases and the death group with 34 cases according to the 28-day survival status after the discharge. The peripheral blood TGF-β1 gene polymorphisms were detected, the levels of peripheral blood IL-8, CRP, GRO-α and U-HBP were compared, and the values of the indexes in prediction of the prognosis of the sepsis patients were analyzed. RESULTS The levels of IL-8, CRP, GRO-α and U-HBP of the sepsis group were higher than those of the control group(P<0.05). The frequencies of CC genotype and C allele at rs1800471 locus of TGF-β1 gene were lower in the sepsis group than in the control group, while the frequencies of GG genotype and allele G were higher in the sepsis group than in the control group(P<0.05). Among the sepsis patients, the levels of IL-8, CRP, GRO-α and U-HBP of the survival group were lower than those of the death group(P<0.05);the frequencies of CC genotype and allele C at TGF-β1 rs1800471 locus were higher in the survival group than in the death group, while the frequencies of GG genotype and allele G were lower in the survival group than in the death group(P<0.05). Receiver operating characteristic(ROC) curve analysis showed that the area under curve of the joint detection of IL-8, CRP, GRO-α and U-HBP was 0.912 in prediction of the prognosis of the sepsis patients, higher than 0.730 of IL-8, 0.770 of CRP, 0.716 of GRO-α, and 0.798 of U-HBP(P<0.05). CONCLUSION The gene polymorphism at TGF-β1 rs1800471 locus is associated with the susceptibility to sepsis and the prognosis. The joint detection of IL-8, CRP, GRO-α and U-HBP has high efficiency in prediction of the prognosis of the sepsis patients.