BTLA基因rs1982809多态性与重度烧伤患者并发脓毒症及其预后的关联

Association between BTLA gene rs1982809 polymorphism and prognosis of severe burn patients complicated with sepsis

目的探讨B和T淋巴细胞弱化因子(BTLA)基因rs1982809多态性对重度烧伤患者脓毒症风险和患者预后的影响。方法选择江苏省泰州市人民医院烧伤科2018年8月-2021年8月因严重烧伤入院接受治疗患者为研究对象,根据患者烧伤后是否发生脓毒症,将其分为脓毒症组和对照组。所有患者均在入院当天采血,以实时荧光定量聚合酶链式反应(RT-PCR)检测BTLA基因rs1982809位点多态性分布。通过电子病历系统调取并收集患者年龄、性别、总体表面积(TBSA)、Ⅲ度烧伤面积、合并吸入性损伤和机械通气情况;根据实验室检查结果统计发生脓毒症患者脓毒症确诊当天C-反应蛋白(CRP)、血乳酸和急性生理与慢性健康评分Ⅱ(APACHEⅡ)情况;统计脓毒症患者入院7 d预后。结果脓毒症组和对照组患者BTLA基因rs1982809位点TT、TC和CC基因型分布实际频数和理论频数比较差异均无统计学意义;脓毒症组携带BTLA基因rs1982809位点CC基因型和C等位基因频率高于对照组,TT基因型和T等位基因频率低于对照组(P<0.05);携带CC基因型脓毒症患者血清血乳酸和APACHEⅡ评分高于TT+TC组,且其7 d死亡人数高于TT+TC组(P<0.05)。结论BTLA基因rs1982809位点CC基因型增加严重烧伤患者发生脓毒症风险,且与病情严重程度及患者预后相关。

OBJECTIVE To investigate the effect of B and T lymphocyte attenuating factor(BTLA)gene rs1982809 polymorphism on the risk for sepsis and prognosis in severe burn patients.METHODS Patients admitted to the burn department of Taizhou People′s Hospital of Jiangsu Province for severe burns from Aug 2018 to Aug 2021 were recruited.According to whether sepsis occurred after burns,they were divided into the sepsis group and control group.Specimen of blood were collected in all patients on the day of admission,and real-time fluorescent quantitative polymerase chain reaction(RT-PCR)was used to detect the polymorphism distribution of BTLA gene rs1982809.The patient′s age,gender,total surface area(TBSA),third degree burn area,combined inhalation injury,and mechanical ventilation were collected through the electronic medical record system.According to the results of laboratory examinations,C-reactive protein(CRP)on the day of sepsis diagnosis in sepsis patients,blood lactic acid and acute physiology and chronic health scoreⅡ(APACHEⅡ)were analyzed.The 7-day prognosis of patients with sepsis after admission were evaluated.RESULTS The genotype distribution of TT,TC and CC at rs1982809 site of BTLA gene between the actual frequency and theoretical frequency in the sepsis group and the control group was not significantly different.The frequency of CC genotype and C allele at rs1982809 of BTLA gene in the sepsis group was higher than that in the control group,while the frequency of TT genotype and T allele was lower than that in the control group(P<0.05).The serum blood lactate and APACHEⅡscores in the patients carrying CC genotype were higher than those in the TT+TC group,and the number of deaths at 7d was higher than that in the TT+TC group(P<0.05).CONCLUSION The CC genotype at rs1982809 of the BTLA gene significantly increases the risk for sepsis in severely burned patients,which is related to the severity of the disease and the prognosis of the patient.