脑梗死医院感染危险因素及与ZNRD1基因多态性的关联

Risk factors for nosocomial infections in cerebral infarction patients and association with ZNRD1 gene polymorphisms

目的探究脑梗死医院感染危险因素及与锌带蛋白基因1(ZNRD1)基因多态性的关联.方法选取2022年3月-2023年5月武汉市汉口医院收治的303例脑梗死患者为研究对象,将发生医院感染及未发生医院感染患者分别纳入感染组52例和非感染组251例.统计脑梗死医院感染现况,通过单因素及多因素分析法分析脑梗死医院感染危险因素.采用限制性片段长度多态性聚合酶链反应(PCR-RFLP)检测两组患者ZNRD1基因多态性.结果303例脑梗死患者医院感染发生52例,医院感染发生率为17.16%;多因素Logistic回归分析结果显示,有糖尿病史、入院时美国国立卫生院卒中量表(NIHSS)评分>3分、有肺部疾病史、有侵入性操作、住院天数长是脑梗死医院感染危险因素(P<0.05).与非感染组相比,感染组ZNRD1 rs16896970位点GG基因型及G等位基因频率升高,AA基因型及A等位基因频率降低(P<0.05).结论脑梗死医院感染发生率高,脑梗死患者医院感染与糖尿病、肺部疾病史、入院时NIHSS评分、侵入性操作及住院天数密切相关,临床可据此予以早期针对性防治而降低脑梗死患者医院感染的发生风险;ZNRD1基因多态性可能参与脑梗死患者医院感染病情进展.

OBJECTIVE To explore the risk factors for nosocomial infections in the patients with cerebral infarction and analyze the association with zinc ribbon domain-containing 1 protein(ZNRD1)gene polymorphisms.METHODS A total of 303 patients with cerebral infarction who were treated in Wuhan Hankou Hospital from Mar 2022 to May 2023 were recruited as the research subjects,52 of whom had nosocomial infection were assigned as the infection group,and 251 did not have nosocomial infection were assigned as the non-infection group.The prev-alence of nosocomial infection in the cerebral infarction patients was statically analyzed,univariate analysis and multivariate analysis were performed for the risk factors for the nosocomial infection in the cerebral infarction pa-tients.The ZNRD1 gene polymorphisms were detected for the two groups of patients by means of polymerase-chain-reaction-restriction-fragment-length polymorphism(PCR-RFLP).RESULTS Among the 303 patients with cerebral infarction,52 had nosocomial infection,with the incidence of nosocomial infection 17.16%.The result of multivariate logistic regression analysis showed that history of diabetes mellitus,national institutes of health stroke scale(NIHSS)score at the admission to hospital more than 3 points,history of pulmonary disease,inva-sive procedure and length of hospital stay were the risk factors for the nosocomial infection in the patients with cerebral infarction(P<0.05).The frequencies of GG genotype and G allele at rs16896970 locus of ZNRD1 were higher in the infection group than in the non-infection group,while the frequencies of AA genotype and A allele of the infection group were significantly lower than those of the non-infection group(P<0.05).CONCLUSION The incidence of nosocomial infection is high among the patients with cerebral infarction.The nosocomial infection is closely associated with the history of diabetes mellitus,history of pulmonary disease,NIHSS score at the admis-sion,invasive procedure and length of hospital stay.It is necessary for the hospital to take targeted prevention and treatment measures in early stage so as to reduce the risk of nosocomial infection in the cerebral infarction patients.The ZNRD1 gene polymorphisms may get involved in the progression of nosocomial infection.