老年慢性病患者肺部感染与CD14及HLA基因多态性的关系

目的分析老年慢性病患者肺部感染与白细胞分化抗原14(CD14)和人类白细胞抗原(HLA)基因多态性的关系。方法选取2017年10月-2019年10月菏泽市单县中心医院老年慢性疾病患者615例,以其中合并肺部感染者97例(15.77%)为研究组,另在未合并肺部感染者中随机抽取92例为对照组,采集两组临床资料,检测并比较两组CD14-159 C/T、CD14-260 C/T和HLA-A、HLA-B和HLA-DRB1基因分布。结果两组患者性别、年龄、体质量指数(BMI)及基础疾病等临床资料比较差异无统计学意义,研究组合并慢性疾病种类较对照组多(P<0.05);两组CD14-159 C/T基因型分布差异显著(P<0.05),研究组CD14-159 C等位基因频率显著低于对照组,T等位基因频率显著高于对照组(P<0.05),两组CD14-260 C/T基因型及等位基因频率比较差异无统计学意义;研究组HLA-A*0101等位基因频率高于对照组,HLA-B*5201和HLA-DRB1*1502等位基因频率低于对照组,差异有统计学意义(P<0.05)。结论合并慢性疾病种类较多的老年慢性疾病患者容易发生肺部感染,感染可能与CD14和HLA基因多态性有关,CD14-159 TT和HLA-A*0101可能为易感基因。

Prevalence of pulmonary infection among elderly patients with chronic diseases and its correlation with gene polymorphisms of CD14 and HLA

OBJECTIVE To investigate the prevalence of pulmonary infection among elderly patients with chronic diseases in Shan County of Heze and observe its correlation with gene polymorphisms of cluster of differentiation antigen 14(CD14) and human leukocyte antigen(HLA). METHODS A total of 615 elderly patients with chronic diseases who were treated in Shanxian Central Hospital of Heze City from Oct 2017 to Oct 2019 were enrolled in the study, 97 patients who were complicated with pulmonary infection were assigned as the study group, and 92 patients who were not complicated with pulmonary infection were randomly chosen as the control group, the clinical data were collected from the two groups of patients, and the distribution of CD14-159 C/T, CD14-260 C/T and HLA-A, HLA-B and HLA-DRB1 were detected and compared between the two groups. RESULTS There were no significant differences in the clinical data such as gender, age, body mass index(BMI) and underlying diseases between the two groups of patients, the number of types of chronic diseases of the study group were significantly larger than that of the control group(P<0.05);there was significant difference in the distribution of CD14-159 C/T genotypes between the two groups(P<0.05), the frequency of CD14-159 C allele of the study group was significantly lower than that of the control group, while the frequency of CD14-159 T allele of the study group was significantly higher than that of the control group(P<0.05).There was no significant difference in the CD14-260 C/T genotypes and frequency of allele between the two groups.The frequency of HLA-A*0101 allele of the study group was significantly higher than that of the control group, the frequencies of HLA-B*5201 and HLA-DRB1*1502 alleles of the study group were significantly lower than those of the control group(P<0.05). CONCLUSION The elderly patients who are complicated with multiple chronic diseases tend to have pulmonary infection, which could be associated with the gene polymorphisms of CD14 and HLA.CD14-159 TT and HLA-A*0101 may be susceptible genes.