RSV毛细支气管炎SP-D基因多态性与甲强龙疗效的关系

摘要

目的 探讨汉族儿童呼吸道合胞病毒(respiratory syncytial virus,RSV)毛细支气管炎肺表面活性蛋白D(surfactant protein D,SP-D)基因多态性与甲强龙治疗疗效的关系.方法 采用MGB测序法检测150例RSV毛细支气管炎和150例健康对照组SP-D-11位点、160位点基因多态性,并进行基因型、等位基因型频率分析,分析基因多态性和毛细支气管炎发病的关系,采用(x2)检验.150例患儿在常规治疗基础上加用甲强龙静脉滴注,连用3d.分析SP-D基因多态性对甲强龙治疗疗效的影响,采用方差(F)分析.结果 病例组SP-D Met11Thr位点TT、CT、CC三种基因型频率分别为7.3％、44.0％、48.7％,T、C等位基因频率分别为29.3％、70.7％.三种基因型及等位基因频率与对照组比较差异有统计学意义(x2 =6.751、5.823,P＜0.05).SP-D Ala160Thr位点AA、GA、GG三种基因型频率分别为4.0％、29.3％、66.7％,A、G等位基因频率分别为18.7％、71.3％,两组基因型及等位基因频率与对照组比较差异无统计学意义(x2 =0.182、0.181,P＞0.05).不同基因型在平均住院天数、临床症状改善差异均无统计学意义(P＞0.05).结论 杭州地区汉族儿童存在SP-D基因多态性,SP-DMet1 1Thr位点与RSV毛细支气管炎疾病易感性存在关联,SP-D Met11Thr C等位基因可能易感基因;而SP-D Ala160Thr位点与RSV毛细支气管炎疾病易感性无关联.SP-DMet1 1Thr、SP-D Ala160Thr的多态性并不影响甲强龙治疗的疗效.%Objective To investigate the influence of genetic polymorphisms within surfactant protein(SP-D) gene on the development of respiratory syncytial virus(RSV) bronchiolitis and the clinical outcomes of the individual response to methylprednisolone therapy in Han ethnicity in Hangzhou.Methods Genotyping of SP-D polymorphisms was performed by polymerase chain reaction and TaqMan MGB probe in 150 cases of RSV bronchitis (case group) and 150 healthy children (control group),and the genotype frequencies and allele frequencies were analyzed simultaneously.Each group' s genotype and allele frequencies were compared with x2 test; 150 cases of bronchiolitis received conventional therapy,using methylprednisolone injection treatment.Analysis on the effect of SP-D gene polymorphism on the methylprednisolone therapy was performed with F test.Results The frequencies of genotypes TT,TC and CC of SP-D Met1 1Thr were 7.3％,44.0％ and 48.7％,respectively,and the allele frequencies of T and C were 29.3％ and 70.7％,respectively.SP-D Met11Thr displayed significant association with RSV as compared with control group (x2 =6.751,5.823,P ＜ 0.05).The frequencies of AA,GA,GG of SP-D Alal60Thr were 4.0％,29.3％ and 66.7 ％,respectively,and the allele frequencies of A and G were 18.7％ and 71.3％.SP-D Ala160Thr displayed no significant association with RSV bronchiolitis as compared with control group (x2 =0.182,0.181,P ＞ 0.05).Different genotypes in the average hospitalization days,clinicalsymptoms had no statistically significant difference (P ＞ 0.05).Conclusion Both SP-D MetllThr and SP-D Ala160Thr gene polymorphisms were present in Han children in Hangzhou area,Polymorphisms of SP-D Metl1Thr displayed significant association with RSV bronchiolitis as compared with control group,SP-D Met11Thr C allele may be a susceptibility gene.Polymorphisms of SP-D Ala160Thr did not correlate with RSV as compared with control group.SP-D variation had no effect on therapeutic response to methylprednisolone in patients with RSV bronchiolitis.