臍帶血IRAK-M基因多態(tài)性與新生兒早產(chǎn)及主要并發(fā)癥的關(guān)系

黃君 王麗珍

[摘要] 目的 探討臍帶血白細(xì)胞介素1受體相關(guān)激酶-M（interleukin-1 receptor-associatd kinase-M，IRAK-M）基因多態(tài)性與新生兒早產(chǎn)及主要并發(fā)癥的關(guān)系。 方法 選擇 2015 年1月～2017 年 12 月本院出生的≤34 周的早產(chǎn)兒 200例為研究對(duì)象，母親分娩時(shí)取臍帶血，測(cè)定 IRAK-M基因位點(diǎn)多態(tài)性;記錄早產(chǎn)兒的臨床資料，分析 IRAK-M基因多態(tài)性與早產(chǎn)兒主要并發(fā)癥的關(guān)系。 結(jié)果 200例早產(chǎn)兒中主要住院情況有創(chuàng)機(jī)械通氣治療、吸氧治療、肺表面活性物質(zhì)應(yīng)用、低血壓或休克、敗血癥、發(fā)生呼吸暫停。早產(chǎn)兒的IRAK1主要基因分型為 rs3027898 （CC、AC 或AA3 種基因型）和rs1059703（CC、CT或TT3種基因型）。rs3027898（AC+AA）和rs1059703（CT+TT）增加了RDS的發(fā)生率，rs3027898（AC+AA）增加了ROP發(fā)生率，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。 結(jié)論 測(cè)定臍帶血IRAK-M基因多態(tài)性可以影響早產(chǎn)兒的主要并發(fā)癥，有助于評(píng)估患兒預(yù)后。

[關(guān)鍵詞] 白細(xì)胞介素1受體相關(guān)激酶-M;多態(tài)性;早產(chǎn);臍帶血

[中圖分類號(hào)] R722.6? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] A? ? ? ? ? [文章編號(hào)] 1673-9701（2019）20-0019-04

Relationship between polymorphism of cord blood IRAK-M gene and premature neonate as well as major complications

HUANG Jun? ?WANG Lizhen

Department of Neonatology， Taizhou Hospital in Zhejiang Province， Linhai? ?317000， China

[Abstract] Objective To investigate the relationship between polymorphism of interleukin-1 receptor-associative kinase-M（IRAK-M） gene and premature delivery as well as major complications in neonates. Methods A total of 200 premature infants（≤34 weeks） born in our hospital from January 2015 to December 2017 were enrolled. The cord blood was taken when the mother gave birth. And the IRAK-M locus polymorphism was determined. The clinical data of premature infants were recorded and the relationship between IRAK-M gene polymorphism and major complications in preterm infants was analyzed. Results The main hospitalizations in 200 preterm infants were invasive mechanical ventilation， oxygen therapy， pulmonary surfactant application， hypotension or shock， sepsis， and apnea. The main genotype of IRAK1 in premature infants is rs3027898（CC， AC or AA genotypes） and rs1059703（CC， CT or TT3 genotypes）. rs3027898 （AC+AA） and rs1059703 （CT+TT） increased the incidence of RDS， and rs3027898 （AC AA） increased the incidence of ROP， and the difference was statistically significant（P<0.05）. Conclusion Measuring IRAK-M gene polymorphism in cord blood can affect the main complications of premature infants and help to assess the prognosis of children.

[Key words] Interleukin-1 receptor-associated kinase-M; Polymorphism; Premature delivery; Cord blood

白細(xì)胞介素1受體相關(guān)激酶（interleukin-1 receptor-associatd kinase-M，IRAK-M）是近年來(lái)發(fā)現(xiàn)的參與機(jī)體先天性免疫反應(yīng)過程的關(guān)鍵絲/蘇氨酸激酶，IRAK家族通過一系列的級(jí)聯(lián)反應(yīng)，參與調(diào)解TOLL樣受體（toll like receptor，TLR）L/IL-1受體家族信號(hào)轉(zhuǎn)導(dǎo)通路，識(shí)別病原相關(guān)分子模式，能在IL-1誘導(dǎo)下和 IL-1R 相結(jié)合[1]。IRAK-M 還調(diào)節(jié)獲得性免疫的發(fā)生和類型，從而構(gòu)成機(jī)體內(nèi)的第一道免疫防線，可參與調(diào)節(jié)多種炎性疾病的發(fā)生發(fā)展[2，3]。但目前針對(duì)白細(xì)胞介素1受體相關(guān)激酶-M（IRAK-M）基因多態(tài)性與早產(chǎn)兒及主要并發(fā)癥的關(guān)系研究較少。本研究通過檢測(cè)臨床孕婦臍帶血IRAK-M+22148G>A多態(tài)位點(diǎn)的基因型，進(jìn)一步探討IRAK-M基因多態(tài)性與新生兒早產(chǎn)及并發(fā)癥的關(guān)系，為新生兒并發(fā)癥的早期診斷和預(yù)后判定提供依據(jù)，為精準(zhǔn)醫(yī)療提供臨床證據(jù)。