摘要
目的 研究重症脑损伤患者干扰素调节因子5(IRF5)基因rs2004640位点突变与肺部感染的关系,并研究其对于肺部感染的预测作用。方法 选取2019年2月-2020年2月哈励逊国际和平医院收治的重症脑损伤患者185例,根据治疗期间肺部感染情况分为感染组、未感染组。分析病原菌的分布特点,采用TaqMan法检测IRF5基因rs2004640位点多态性。分析IRF5基因rs2004640位点与肺部感染的关系,采用单因素、多因素Logistic回归分析影响肺部感染的危险因素。结果 IRF5基因rs2004640位点的TT基因型85例、GT基因型56例、GG基因型44例,T和G等位基因频率分别为61.08%和38.92%;65例发生感染,共分离出88株病原菌;感染组患者的IRF5基因rs2004640位点TT基因型、T等位基因频率高于未感染组(P<0.05);Logistic回归分析显示,年龄、入院时格拉斯哥昏迷评分(GCS)、住院时间、糖尿病、意识障碍、营养不良、机械通气、抗菌药物联用、IRF5基因rs2004640位点多态性均是影响患者肺部感染的独立危险因素(P<0.05);IRF5基因rs2004640位点突变预测肺部感染的敏感度为41.84%,特异度为86.36%,阳性预测值为90.77%。结论 IRF5基因rs2004640位点突变与重症脑损伤患者并发肺部感染密切关联,其中TT基因型可能增加肺部感染风险,该位点基因突变能够良好地预测肺部感染。
OBJECTIVE To explore the relationship between rs2004640 site mutation of interferon regulatory factor 5(IRF5)gene and pulmonary infection in patients with severe brain injury,and to analyze its predictive effect on pulmonary infection.METHODS A total of 185 patients with severe brain injury who were admitted to Harrison International Peace Hospital from Feb 2019 to Feb 2020 were included and divided into the infected group and uninfected group according to whether pulmonary infection occurred during treatment.The distribution characteristics of pathogens were analyzed,and the polymorphism of IRF5 RS2004640 was detected by TaqMan method.The relationship between IRF5 RS2004640 polymorphism and pulmonary infection was analyzed,and the risk factors for pulmonary infection were analyzed by univariate and multivariate logistic regression analysis.RESULTS Eighty-five cases of TT genotype,56 cases of GT genotype and 44 cases of GG genotype at rs2004640 locus of IRF5 gene were detected,with the frequencies of T and G alleles of 61.08%and 38.92%,respectively.Sixty-five patients were infected,from which 88 strains were isolated.The frequency of TT genotype and T allele at rs2004640 of IRF5 gene in the infected group was significantly higher than that in the uninfected group(P<0.05).Multivariate logistic regression analysis showed that age,GCS score at admission,length of hospital stay,diabetes,disturbance of consciousness,malnutrition,mechanical ventilation,antibiotic combination and gene polymorphism of IRF5 rs2004640 were independent influencing factors for pulmonary infection(P<0.05).The sensitivity,specificity,and positive predictive value of rs2004640 IRF5 gene polymorphism in the prediction of pulmonary infection were 41.84%,86.36%and 90.77%,respectively.CONCLUSION Site mutation of IRF5 Rs2004640 gene locus is closely associated with pulmonary infection in patients with severe brain injury.TT genotype may increase the risk for lung infection,which is efficient predictor of lung infection.
作者
纪飞
高茜
王茜
李玲
JI Fei;GAO Qian;WANG Qian;LI Ling(Harrison International Peace Hospital,Hengshui,Hebei O53000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2023年第15期2315-2319,共5页
Chinese Journal of Nosocomiology
基金
河北省医学科学研究计划基金资助项目(20220457)。
关键词
干扰素调节因子5
重症脑损伤
肺部感染
病原菌
基因多态性
预测价值
危险因素
关联
Interferon regulatory factor 5
Severe brain injury
Pulmonary infection
Pathogen
Gene polymorphism
Predictive value
Risk factor
Association