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目的探讨血浆纤溶酶原激活物抑制剂-1(PAI-1)基因启动子区单核苷酸缺失/插入(4G/5G)多态性与脓毒症易感性和转归的相关性。方法采用聚合酶链反应、限制性内切酶分析、16%聚丙烯酰胺凝胶电泳结合溴化乙锭染色法,测定89例术后并发严重脓毒症的患者(脓毒症组)和100例术后未并发脓毒症的患者(对照组)PAI-1基因启动子区4G/5G多态性的基因型。结果脓毒症组患者急性生理与慢性健康状况评分Ⅱ评分为22.5±2.1,死亡率为51%;脓毒症组患者PAI-14G/4G基因型携带频率为0.44,4G等位基因携带频率为0.65;对照组分别为0.25和0.50;两组比较差异有统计学意义。脓毒症组中,死亡患者4G/4G基因型携带频率为0.54,存活者为0.34;两者比较差异有统计学意义。结论PAI-1基因启动子区4G/5G多态性与脓毒症的易感性和转归相关,4G纯合子、4G等位基因是脓毒症易感的预警指标,4G纯合子为脓毒症死亡的高危遗传标志。
Objective To investigate the association between single nucleotide polymorphism (4G / 5G) polymorphisms in plasminogen activator inhibitor-1 (PAI-1) promoter and susceptibility to sepsis. Methods 89 patients with severe sepsis (sepsis group) and 100 (sepsis group) were determined by polymerase chain reaction, restriction endonuclease analysis and 16% polyacrylamide gel electrophoresis with ethidium bromide staining. Cases of patients with non-concurrent sepsis (control group) PAI-1 gene promoter region 4G / 5G polymorphism genotype. Results The score of acute physiology and chronic health status score Ⅱ in sepsis group was 22.5 ± 2.1 and the mortality rate was 51%. The frequency of PAI-14G / 4G genotype in sepsis group was 0.44, and the allele of G allele was 0.65; control group were 0.25 and 0.50 respectively; the difference between the two groups was statistically significant. In the sepsis group, the frequency of 4G / 4G genotypes of death patients was 0.54 and the survival rate was 0.34. The difference between the two groups was statistically significant. Conclusion 4G / 5G polymorphism of PAI-1 gene promoter is associated with the susceptibility to sepsis and prognosis. 4G homozygote and 4G allele are predisposing markers of sepsis, 4G homozygote is sepsis High risk of death from genetic markers.