摘要 目的探索胆总管结石(CBDS)胰胆管造影术(ERCP)后急性胆囊炎与白细胞介素-6(IL-6)基因多态性间的关系。方法回顾性分析2016年10月-2019年10月在天津市第五中心医院行ERCP术的186例CBDS患者,根据术后是否发生急性胆囊炎分为急性胆囊炎组(n=35)和非急性胆囊炎组(n=151)。记录患者年龄、性别、合并基础病等。分别于术前、术后3 d和术后7 d,检测血清IL-6、肿瘤坏死因子-α(TNF-α)和C-反应蛋白(CRP)水平;术前检测IL-6基因rs1800795(-174G/C)、rs1800796(-572G/C)和rs1800797(-597G/A)位点多态性。Logistic回归分析影响ERCP术后急性胆囊炎发生的危险因素。结果急性胆囊炎组患者术后3 d和7 d血清IL-6、TNF-α和CRP水平高于非急性胆囊炎组患者(P<0.05),IL-6基因-572C/G位点基因型CC、CG和GG分布频数与非急性胆囊炎组比较,具有统计学差异(P<0.05),等位基因C的频率低于非急性胆囊炎组(P<0.05);术后7 d血清IL-6(OR=1.964,P=0.020)、TNF-α(OR=1.931,P=0.031)、CRP(OR=1.939,P=0.028)和IL-6基因-572C/G位点多态性(OR=1.908,P=0.038)均为影响ERCP术后急性胆囊炎发生的独立因素;术后3 d和术后7 d,IL-6基因-572C/G位点基因型为CC患者的血清IL-6、TNF-α和CRP水平低于基因型为CG+GG患者(P<0.05)。结论IL-6基因-572C/G位点多态性与CBDS患者ERCP术后血清IL-6、TNF-α、CRP水平有关,是影响术后急性胆囊炎发生的独立因素。 OBJECTIVE To explore the correlation between the postoperative acute cholecystitis and the interleukin-6(IL-6)gene polymorphism in the common bile duct stones(CBDS)patients undergoing endoscopic retrograde cholangiopancreatography(ERCP).METHODS A total of 186 patients with CBDS who underwent ERCP in Tianjin Fifth Central Hospital from Oct 2016 to Oct 2019 were retrospectively analyzed and divided into the acute cholecystitis group with 35 cases and the non-acute cholecystitis group with 151 cases according to the status of postoperative acute cholecystitis.The age,gender and underlying diseases of the patients were recorded.The levels of serum IL-6,tumor necrosis factor-α(TNF-α)and C-reactive protein(CRP)were detected before the surgery and after the surgery for 3 and 7 days;the IL-6 gene polymorphisms at rs1800795(-174 G/C),rs1800796(-572 G/C)and rs1800797(-597 G/A)loci were detected before the surgery.Logistic regression analysis was performed for risk factors for the postoperative acute cholecystitis in the ERCP patients.RESULTS The levels of serum IL-6,TNF-αand CRP of the acute cholecystitis group were significantly higher than those of the non-acute cholecystitis group after the surgery for 3 and 7 days(P<0.05).There were significant differences in the distribution frequencies of IL-6 gene genotypes(CC,CG,GG)at-572 C/G locus between the acute cholecystitis group and the non-acute cholecystitis group(P<0.05);the frequency of allele C of the acute cholecystitis group was significantly lower than that of the non-acute cholecystitis group(P<0.05).The levels of serum IL-6(OR=1.964,P=0.020),TNF-α(OR=1.931,P=0.031)and CRP(OR=1.939,P=0.028)after the surgery for 7 days and the IL-6 gene polymorphism at 572 C/G locus were the independent influencing factors for the postoperative acute cholecystitis in the ERCP patients.The levels of serum IL-6,TNF-αand CRP of the patients with CC genotype at IL-6 gene-572 C/G locus were significantly lower than those of the patients with CG+GG genotype after the surgery for 3 and
出处 《中华医院感染学杂志》 CAS CSCD 北大核心 2021年第6期896-900,共5页 Chinese Journal of Nosocomiology
基金 天津市滨海新区卫生计生委科技基金资助项目(2018BWKY018)。
关键词 胆总管结石 内镜下逆行胰胆管造影术 急性胆囊炎 白细胞介素-6 单核苷酸多态性 Common bile duct stones Endoscopic retrograde cholangiopancreatography Acute cholecystitis Interleukin-6 Single nucleotide polymorphism
