CD14基因多态性与烧伤后严重脓毒症易感性及患者预后的关系

目的　探讨内毒素受体 CD14 C 15 9T基因多态性与烧伤后严重脓毒症易感性及患者预后的关系。方法　研究对象包括 118例健康献血员和 16例烧伤面积大于 6 0 %全身体表总面积的患者 ,通过分析Hae 消化聚合酶链反应 (PCR)产物的片段 ,对其进行 CD14 C 15 9T基因多态性检测。研究 CD14基因型的分布与严重脓毒症易感性及病死率的关系。结果　 16例烧伤患者的等位基因频率 (C4 3.7% ,T5 6 .3% )及基因型分布 (C纯合子占 12 .5 % ,C/T占 6 2 .5 % ,T纯合子占 2 5 .0 % )与健康献血员一致。发生严重脓毒症患者与非脓毒症患者基因型分布明显不同 ,严重脓毒症组 T等位基因频率 (71.4 % )高于非脓毒症组 (44 .4 % ) ,TT纯合子患者发生严重脓毒症的比例有所增高。结论　 CD14 C 15 9T基因多态性可能对烧伤后严重脓毒症的发生具有一定影响。

Association between a genomic polymorphism within the CD14 locus and severe sepsis susceptibility as well as prognosis in patients after extensive burns

OBJECTIVE: To investigate the relation of a lipopolysaccharide receptor CD14C-159T gene polymorphism to severe sepsis susceptibility and prognosis in patients with extensive burns. METHODS: The study group consisted of 118 normal controls and 16 patients with burns covering more than 60 percent total body surface area. Typing of each patient for the CD14C-159T gene polymorphism was performed by analyzing restriction fragments of a Hae III-digested DNA fragment obtained using polymerase chain reaction (PCR-RFLP). Genotypes were then related to the susceptibility and mortality rate of severe sepsis. RESULTS: The overall allele frequency (C 43.7 percent, T 56.3 percent) and genotype distribution (C homozygous 12.5 percent, C/T 62.5 percent, T homozygous 25.0 percent) were in agreement with the distribution in healthy volunteers. Genotype distribution in patients with severe sepsis was different from that in patients with an uncomplicated clinical course. Development of severe sepsis was increased in patients homozygous for the allele T (71.4 percent) than that of the non- sepsis patients (44.4 percent). CONCLUSION: The single base pair polymorphism at position-159 in the CD14 gene promoter might influence the development of severe sepsis in patients with extensive burns.