老年慢性心力衰竭患者肺部感染与CYP27B1基因多态性的关联及血清CHE和H-FABP与S100A12表达水平

Correlation of pulmonary infection with CYP27B1 gene polymorphism and expression levels of serum CHE,H-FABP and S100A12 in elderly patients with chronic heart failure

目的探讨老年慢性心力衰竭(CHF)患者肺部感染与25ohd-2c3-1α羟化酶(CYP27B1)基因多态性的关联及血清胆碱酯酶(CHE)、心型脂肪酸结合蛋白(H-FABP)、钙结合蛋白(S100A12)水平表达意义.方法选取浙江省安吉县人民医院2020年7月—2023年7月收治的老年CHF患者114例,根据肺部感染情况分为感染组/未感染组(26例/88例);分析两组临床资料和病原菌分布情况;分别采用丁酰硫代胆碱法和酶联免疫吸附法检测CHE、H-FABP、S100A12水平;采用受试者工作特征(ROC)曲线分析三者对老年CHF患者肺部感染的诊断价值;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CYP27B1基因多态性.结果老年CHF患者肺部感染患者分离出37株病原菌,多为革兰阴性菌;感染组血清CHE水平比未感染组低(P<0.05),血清H-FABP、S100A12水平比未感染组高(P<0.05);绘制ROC曲线获得CHE、H-FABP、S100A12联合检测诊断老年CHF患者肺部感染的曲线下面积(AUC)比各项单独检测高(P<0.05),敏感度88.50%,特异度78.40%;感染组CYP27B1-1260位点AA基因型频率和A等位基因频率与未感染组比更低(P<0.05),CC基因型频率和C等位基因频率与未感染组比更高(P<0.05).结论老年CHF患者肺部感染发生率较高,多为革兰阴性菌感染,且感染发生后血清CHE呈低表达,H-FABP、S100A12呈高表达,联合检测CHE、H-FABP、S100A12有助于诊断老年CHF患者肺部感染,CYP27B1基因多态性可能参与老年CHF患者肺部感染.

OBJECTIVE To investigate the correlation of pulmonary infection with 25ohd-2c3-1αhydroxylase(CYP27B1)gene polymorphism,the expression significance of serum cholinesterase(CHE),cardiac fatty acid-binding protein(H-FABP)and calc-binding protein(S100A12)in elderly patients with chronic heart failure(CHF).METHODS A total of 114 elderly CHF patients admitted to Anji County People's Hospital in Zhejiang Province from Jul 2020 to Jul 2023 were recruited and divided into the infected group(26 cases)and uninfected group(88 cases)according to whether pulmonary infection occurred.Clinical data and pathogenic bacteria distribu-tion were analyzed in the two groups.Levels of CHE,H-FABP and S100A12 were detected by butyryl thiocholine assay and enzyme-linked immunosorbent assay,respectively.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of the three indexes for pulmonary infection in elderly patients with CHF.Re-striction fragment length polymorphism polymerase chain reaction(PCR-RFLP)was used to detect CYP27B1 gene polymorphism in two groups.RESULTS Thirty-seven strains of pathogenic bacteria were isolated from elderly CHF patients with pulmonary infection,most of which were gram-negative bacteria.Serum CHE level in the in-fected group was lower than that in the uninfected group(P<0.05),while serum H-FABP and S100A12 levels were higher than those in the uninfected group(P<0.05).The area under the curve(AUC)of CHE,H-FABP and S100A12 combined detection in the diagnosis of lung infection in elderly CHF patients was higher than that of each single detection(P<0.05),and the sensitivity and specificity were 88.50%and 78.40%,respectively.The frequencies of AA genotype and A allele of CYP27B1-1260 were lower in the infected group than those in the unin-fected group(P<0.05),while the CC genotype frequency and C allele frequency were higher in the uninfected group than those in the infected group(P<0.05).CONCLUSION The incidence of pulmonary infection in elderly patients with CHF is high,mostly caused by gram-negative bacteria infection.The expression level of CHE in ser-um after infection is low,while the expression levels of H-FABP and S100A12 are high.The combined detection of CHE,H-FABP and S100A12 is helpful for the diagnosis of pulmonary infection in elderly patients with CHF.CYP27B1 gene polymorphism might be involved in pulmonary infection in elderly patients with CHF.