John Baier R, Loggins John, Yanamandra Krishna
Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba R3E 0L8, Canada.
J Perinatol. 2005 Mar;25(3):205-9. doi: 10.1038/sj.jp.7211231.
This study compared the effect of the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphisms on the incidence and outcome of sepsis in ventilated very low birth weight infants.
Infectious complications were retrospectively determined in 295 (234 African-American, 58 Caucasian and three Hispanic) mechanically ventilated very low birth weight (VLBW) infants (<1500 g at birth) and compared ACE I/D genotype.
The incidence of the D allele in the study population was 0.60. A total of 113 (38.3%) infants were homozygous DD, 128 (43.4%) were heterozygous ID and 54 (18.3%) were homozygous II. One or more episodes of late BSI developed in 28 (52%) of 54 infants with the II genotype, 66 (52%) of 128 infants with the ID genotype and 52 (46%) of 113 infants with the DD genotype (p=0.618). Neither the rates of non-CONS BSI (II: 24%, ID: 23%, DD: 22%; p=0.937) nor multiple bacteremic/fungemic episodes (II: 13%, ID: 16%, DD: 12%; p=0.641) were different between genotype groups. The ACE I/D polymorphism had no effect on sepsis-related mortality (II: 7%, ID: 5%, DD: 4%; p=0.692). Sepsis mortality for infants with late BSI was 14% in infants with the II genotype, 9% with the ID genotype and 10% with the DD genotype (p=0.764).
The ACE I/D polymorphism does not have a significant effect on the incidence or outcome of sepsis in ventilated VLBW infants.
本研究比较血管紧张素转换酶（ACE）插入/缺失（I/D）多态性对机械通气的极低出生体重儿败血症发病率及预后的影响。
对295例（234例非裔美国人、58例白种人和3例西班牙裔）机械通气的极低出生体重（VLBW）婴儿（出生时体重<1500g）的感染并发症进行回顾性判定，并比较ACE I/D基因型。
研究人群中D等位基因的发生率为0.60。共有113例（38.3%）婴儿为纯合子DD，128例（43.4%）为杂合子ID，54例（18.3%）为纯合子II。54例II基因型婴儿中有28例（52%）发生1次或多次晚期血流感染（BSI），128例ID基因型婴儿中有66例（52%），113例DD基因型婴儿中有52例（46%）（p=0.618）。基因型组之间非凝固酶阴性葡萄球菌BSI发生率（II：24%，ID：23%，DD：22%；p=0.937）及多次菌血症/真菌血症发作率（II：13%，ID：16%，DD：12%；p=0.641）均无差异。ACE I/D多态性对败血症相关死亡率无影响（II：7%，ID：5%，DD：4%；p=0.692）。晚期BSI婴儿的败血症死亡率在II基因型婴儿中为14%，ID基因型婴儿中为9%，DD基因型婴儿中为10%（p=0.764）。
ACE I/D多态性对机械通气的极低出生体重儿败血症的发病率或预后无显著影响。
