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目的 TNF α可致败血症患儿血液动力学异常。淋巴毒素 α基因的第一内含子的多态性与TNF α分泌增多有关。我们试图证实伴A/A高分泌基因型的菌血症患儿血TNF α水平高且预后差。方法 菌血症患儿基因分型采用PCR扩增和限制性内切酶消化法。用ELISA方法检测血清TNF α。结果 淋巴毒素 α +2 5 0位点基因型检测频率 :A/A为 11/ 3 4(3 2 % ) ,G/A为 16/ 3 4(47% ) ,G/G为 7/ 3 4(2 1% )。A/A基因型菌血症患儿血清TNF含量为 (3 2 4± 12 4)pg/ml,而A/G型为 (92± 5 9)pg/ml(P <0 .0 0 1) ,G/G型为 (92± 2 1)pg/ml(P <0 .0 0 1)。 11例A/A基因型菌血症患儿中 8例死亡 ,而 16例A/G型患儿仅死亡 3人 (P <0 .0 0 1) ,7例G/G型患儿均存活 (P <0 .0 0 1)。结论 淋巴毒素 α +2 5 0位点A/A基因型与菌血症患儿血清TNF 浕水平高且高病死率有关
Objective TNF α can cause hemodynamic abnormalities in children with sepsis. The first intron polymorphism of the lymphotoxin alpha gene is associated with an increase in TNF [alpha] secretion. We attempted to demonstrate high blood levels of TNFa and poor prognosis in children with bacteremia with the A / A high secretion genotype. Methods Bacteremia children genotyping using PCR amplification and restriction endonuclease digestion. Serum TNFα was detected by ELISA. Results The genotype frequencies of α + 250 loci were 11/34 (32%) for A / A, 16/34 (47%) for G / A and 7/34 for G / G (twenty one% ). The level of serum TNF in children with A / A genotype was (3 2 4 ± 12 4) pg / ml, while that of A / G was (92 ± 5 9) pg / ml (P 0 01) , G / G type was (92 ± 2 1) pg / ml (P <0. 001). Of 11 children with A / A genotype, 8 died, while 16 of 16 A / G children died of three (P <0.01). Seven of the G / G children survived (P <0. 0 0 1). Conclusion The genotype of A + 250 locus of lymphotoxin is associated with high serum TNF 浕 level and high mortality in children with bacteremia