表面活性蛋白基因多态性与剖宫产产妇尿路感染的关联

Association of SP-D gene polymorphisms with urinary tract infection in cesarean section puerpera

目的分析表面活性蛋白(SP-D)基因多态性与剖宫产产妇尿路感染(UTI)的关联,为临床预防感染提供参考。方法选取2017年1月-2022年1月新乡市中心医院收治的剖宫产产后UTI产妇82例为感染组,随机选取同期剖宫产产后未发生UTI感染产妇82例为未感染组,分析UTI感染病原学特点,酶联免疫吸附法(ELISA)检测血清降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6、C-反应蛋白(CRP)、SP-D蛋白及尿SP-D蛋白水平;聚合酶链反应-序列特异性引物法(PCR-SSPs)检测SP-D基因Thr11Met和Thr160Ala位点基因分布。结果82例剖宫产产后UTI产妇送检尿标本共分离95株病原菌,其中革兰阴性菌68株占71.58%,革兰阳性菌27株占28.42%;两组SP-D Thr11Met位点基因型分布有统计学差异(P<0.05),感染组Met/Met基因型和11Met等位基因频率均高于未感染组(P<0.05);感染组产妇血清PCT、TNF-α、IL-6、CRP、SP-D水平均高于未感染组(P<0.05),尿SP-D水平低于未感染组(P<0.05)。结论剖宫产产后UTI产妇SP-D等位基因11Met的频率和血SP-D蛋白水平升高,且SP-D蛋白可能通过调节血清免疫炎症因子水平,参与感染的发生。

OBJECTIVE To explore the association of polymorphism of surfactant protein(SP-D)gene with urinary tract infection(UTI)in cesarean section puerpera so as to provide guidance for clinical prevention of infection.METHODS From Jan 2017 to Jan 2022,a total of 82 puerpera who had UTI in Xinxiang Central Hospital after cesarean section were assigned as the infection group,meanwhile,82 puerpera who did not have UTI after cesarean section were chosen as the no infection group.The etiological characteristics of UTI were analyzed.The levels of serum procalcitonin(PCT),tumor necrosis factor(TNF)-α,interleukin(IL)-6,C-reactive protein(CRP),SP-D protein and urine SP-D protein were detected by enzyme-linked immunosorbent assay(ELISA).The genotypes at Thr11Met and Thr160Ala loci of SP-D gene were detected by polymerase chain reaction-sequence-specific primers(PCR-SSPs).RESULTS Totally 95 strains of pathogens were isolated from submitted urine specimens of the 82 cesarean section puerpera with UTI,68(71.58%)of which were gram-negative bacteria,and 27(28.42%)were gram-positive bacteria.There was significant difference in the distribution of genotypes at SP-D Thr11Met locus between the two groups(P<0.05).The frequencies of Met/Met genotype and 11Met allele of the infection group were higher than those of the no infection group(P<0.05).The levels of serum PCT,TNF-α,IL-6,CRP and SP-D of the infection group were higher than those of the no infection group(P<0.05),while the urine SP-D level of the infection group was lower than that of the no infection group(P<0.05).CONCLUSION The frequency of allele 11Met of SP-D gene is increased among the cesarean section puerpera with UTI,and the SP-D protein may be involved in occurrence of infection by regulating the lefels of serum immune inflammatory factors.