Hildebrand Frank, Kalmbach Matthias, Kaapke Andrea, Krettek Christian, Stuhrmann Manfred
Trauma Department, Medical School Hannover, Carl Neuberg Strasse 1, 30625 Hannover, Germany.
Cytokine. 2009 Jul;47(1):30-6. doi: 10.1016/j.cyto.2009.04.002. Epub 2009 May 15.
Procalcitonin (PCT) is accepted to be a relevant prognostic marker for the development of clinical complications in multiple trauma patients. Therefore, a prospective cohort study was conducted to investigate whether polymorphisms in the calcitonin (CALCA) gene are associated with PCT levels and posttraumatic complications.
During a 14day observation period, blood samples were drawn once daily for systemic PCT concentrations in multiple trauma patients (Injury Severity Score >16). For analysis of allele frequencies, genotype distribution and PCT concentrations polytraumatized patients were separated, according to the development of SIRS, sepsis, septic shock, ARDS, MODS and mortality. Furthermore, association between CALCA polymorphisms and PCT plasma concentrations was assessed.
One hundred thirty seven patients with a mean ISS of 29.2+/-12.1 were included. When trauma patients were grouped according to different posttraumatic complications no association with CALCA SNPs was observed. Additionally, no association was found between CALCA polymorphisms and systemic PCT levels.
CALCA polymorphisms are unlikely to influence clinical outcome in polytraumatized patients. Effects of microbial and inflammatory mediators, as well as other risk factors (gender, age, etc.) seem to have a more significant influence on the transcriptional regulation of CALCA and on PCT plasma concentrations than CALCA polymorphisms.
降钙素原（PCT）被认为是多发伤患者临床并发症发生的相关预后标志物。因此，开展了一项前瞻性队列研究，以调查降钙素（CALCA）基因多态性是否与PCT水平及创伤后并发症相关。
在14天的观察期内，每天采集多发伤患者（损伤严重度评分>16）的血样以检测全身PCT浓度。为分析等位基因频率、基因型分布和PCT浓度，根据全身炎症反应综合征（SIRS）、脓毒症、感染性休克、急性呼吸窘迫综合征（ARDS）、多器官功能障碍综合征（MODS）及死亡率的发生情况，将多发伤患者分组。此外，评估CALCA基因多态性与PCT血浆浓度之间的关联。
纳入137例平均损伤严重度评分为29.2±12.1的患者。当根据不同的创伤后并发症对创伤患者进行分组时，未观察到与CALCA单核苷酸多态性（SNP）有关联。此外，未发现CALCA基因多态性与全身PCT水平之间存在关联。
CALCA基因多态性不太可能影响多发伤患者的临床结局。微生物和炎症介质以及其他危险因素（性别、年龄等）的影响似乎比CALCA基因多态性对CALCA的转录调控及PCT血浆浓度具有更显著的影响。
