肿瘤坏死因子基因微卫星与术后并发严重感染患者的易感性及预后的相关研究

目的：调查肿瘤坏死因子（TNF）基因微卫星TNFa、TNFb与术后并发严重感染的易感性及预后的相关性。方法：采用改良巢式聚合酶链反应结合聚丙烯酰胺凝胶电泳、银染色测定122例术后并发严重感染患者和138名健康献血员（对照组）的微卫星TNFa、TNFb的基因型。结果：微卫星TNFa、TNFb分别含有14种等位基因（TNFal-14）和5种等位基因（TNFb1,3-5,7）。等位基因TNFa6分布频率在术后并发严重感染患者中显著高于对照组（分别为20．1％和10．5％,P＜0．05）,等位基因TNFa2分布频率在术后并发严重感染患者中显著低于对照组（分别为21．3％和31．5％,P＜0．05）。在术后并发严重感染患者中,等位基因TNFa10的分布频率在死亡组中显著高于存活组（分别为19．5％和9．5％,P＜0．05）。微卫星TNFb的等位基因分布频率在严重感染组成对照组、严重感染死亡组与存活组间无显著性差异（P＞0．05）。结论：微卫星TNFa与术后并发严重感染的易感性及预后有关,而微卫星TNFb则与术后并发严重感染的易感性及预后无关。

Association of tumor necrosis factor microsatellites TNF with the susceptibility to and outcome of postoperative severe sepsis

Objective To investigate whether tumor necrosis factor microsatellites TNFa and TNFb were associated with the susceptibility to and outcome of postoperative severe sepsis. Methods 122 postoperative patients suffering from severe sepsis and 138 ethnically matched healthy individuals (controls) were included in this study. The genotypes of microsatellites TNFa and TNFb were analyzed using modified nested PCR followed by polyacrylamide gel electrophoresis with silver staining. Results Microsatellites TNFa and TNFb consisted of 14 alleles (TNFa1 14) and 5 alleles (TNFb1, 3 5, 7) respectively. The frequency of TNFa6 microsatellite allele was significantly higher in patients with severe sepsis than in controls (20.1% versus 10.5%, P <0.05). The frequency of TNFa2 microsatellite allele was significantly lower in patients with severe sepsis than in controls (21 3% versus 31.5%, P <0.05). Furthermore, among patients with severe sepsis, the frequency of TNFa10 microsatellite allele was significantly higher in non survivors than in survivors (19.5% versus 9.5%, P <0.05). Whereas, there was no significant difference in the distribution of TNFb microsatellite alleles between patients and controls, and non survivors and survivors (both P >0.05). Conclusion Microsatellite TNFa is significantly associated with both the susceptibility to and outcome of severe sepsis. In contrast, microsatellite TNFb is neither associated with the susceptibility to severe sepsis nor with the outcome of severe sepsis.