IRF5基因多态性与sICAM1及25(OH)D和新生儿肺部感染的关联

Association between IRF5 gene polymorphism,sICAM1 and 25(OH)D and pulmonary infection in neonates

目的 探讨新生儿肺部感染病原菌和干扰素调节因子5(IRF5)基因多态性、血清可溶性细胞间黏附分子1(sICAM1)、25羟维生素D[25(OH)D]的关联.方法 回顾性收集2020年1月-2022年6月孝感市中心医院收治的90例肺部感染新生儿临床资料,根据新生儿病情程度将其分为轻症组(48例)、重症组(42例),选取同期于医院分娩、未发生肺部感染的97名新生儿临床资料作为健康对照组,统计肺部感染新生儿感染病原菌分布,比较三组IRF5基因多态性、血清sICAM1、25(OH)D及炎症指标水平.结果 90例肺部感染新生儿共培养分离病原菌99株,其中革兰阴性菌74株占74.75%,革兰阳性菌25株占25.25%,以肺炎克雷伯菌、大肠埃希菌、金黄色葡萄球菌为主;健康对照组、轻症组、重症组IRF5 rs2004640基因多态性位点TT基因频率呈升高趋势(P<0.05);IRF5 rs2004640基因多态性位点GG基因频率呈降低趋势(P<0.05);健康对照组、轻症组、重症组血清sI-CAM1、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)、C-反应蛋白(CRP)水平呈升高趋势(P<0.05);血清25(OH)D水平呈降低趋势(P<0.05).结论 新生儿肺部感染病原菌以肺炎克雷伯菌、大肠埃希菌、金黄色葡萄球菌、肺炎链球菌为主,IRF5 rs2004640基因多态性分布与新生儿肺部感染有关,同时肺部感染可引起新生儿血清sI-CAM1 水平升高、血清25(OH)D水平降低.

OBJECTIVE To explore the pathogenic bacteria of neonatal lung infection,interferon regulatory factor 5(IRF5)gene polymorphism,serum soluble intercellular adhesion molecule 1(sICAM1),and 25 hydroxyvitamin D[25(OH)D].METHODS The clinical data of 90 neonates with pulmonary infection admitted to Xiaogan Central Hospital from Jan.2020 to Jun.2022 were retrospectively collected,and the neonates were divided into the mild disease group(48 cases)and the severe disease group(42 cases)according to the severity of the disease.The clinical data of 97 neonates delivered in hospital during the same period without pulmonary infection were selected as the healthy control group.The distribution of pathogenic bacteria in neonates with pulmonary infection was analyzed,and the levels of IRF5 gene polymorphism,serum sICAMl,25(OH)D and inflammation indexes were compared among the three groups.RESULTS A total of 99 strains of pathogenic bacteria were isolated from 90 neonates with pulmonary infection,of which 74 gram-negative strains accounted for 74.75%,25 gram-positive strains accounted for 25.25%,mainly Klebsiella pneumoniae,Escherichia coli Staphylococcus aureus and Streptococcus pneumoniae.The TT gene frequency of IRF5 rs2004640 gene polymorphic locus was increased in the healthy control group,the mild disease group and the severe disease group(P<0.05),while the GG gene frequency of IRF5 rs2004640 gene polymorphic site was decreased(P<0.05).The levels of serum sICAMl,tumor necrosis factor-α(TNF-α),procalcitonin(PCT)and C-reactive protein(CRP)in the healthy control group,the mild disease group and the severe disease group were increased(P<0.05),while the level of serum 25(OH)D was decreased(P<0.05).CONCLUSION Klebsiella pneumoniae,Escherichia coli,Staphylococcus aureus and Streptococcus pneumoniae were the main pathogens of neonatal lung infection.IRF5 rs2004640 gene polymorphism was associated with neonatal lung infection,while pulmonary infection could cause increased serum sICAMl levels and decreased serum 25(OH)D levels.