严重脓毒症患者携带线粒体 DNA Haplogroup JT 显示更高的生存率：一项前瞻性、多中心、观察性研究。
Severe septic patients with mitochondrial DNA haplogroup JT show higher survival rates: a prospective, multicenter, observational study.
机构信息
Intensive Care Unit, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain.
出版信息
PLoS One. 2013 Sep 12;8(9):e73320. doi: 10.1371/journal.pone.0073320. eCollection 2013.
OBJECTIVE
In a previous cohort study (n=96), we found an association between mitochondrial (mt) DNA haplogroup JT and increased survival of severe septic patients, after controlling for age and serum lactic acid levels. The aim of this research was to increase the predictive accuracy and to control for more confounder variables in a larger cohort (n=196) of severe septic patients, to confirm whether mtDNA haplogroup JT influences short and medium-term survival in these patients.
METHODS
We conducted a prospective, multicenter, observational study in six Spanish Intensive Care Units. We determined 30-day and 6-month survival and mtDNA haplogroup in this second cohort of 196 patients and in the global cohort (first and second cohorts combined) with 292 severe septic patients. Multiple logistic regression and Cox regression analyses were used to test for the association of mtDNA haplogroups JT with survival at 30-days and 6-months, controlling for age, sex, serum interleukin-6 levels and SOFA score.
RESULTS
Logistic and Cox regression analyses showed no differences in 30-day and 6-month survival between patients with mtDNA haplogroup JT and other haplogroups in the first cohort (n=96). In the second cohort (n=196), these analyses showed a trend to higher 30-day and 6-month survival in those with haplogroup JT. In the global cohort (n=292), logistic and Cox regression analyses showed higher 30-day and 6-month survival for haplogroup JT. There were no significant differences between J and T sub-haplogroups in 30-day and 6-month survival.
CONCLUSIONS
The global cohort study (first and second cohorts combined), the largest to date reporting on mtDNA haplogroups in septic patients, confirmed that haplogroup JT patients showed increased 30-day and 6-month survival. This finding may be due to single nucleotide polymorphism defining the whole haplogroup JT and not separately for J or T sub-haplogroups.
目的
在之前的一项队列研究（n=96）中，我们发现线粒体（mt）DNA 单倍群 JT 与控制年龄和血清乳酸水平后严重脓毒症患者的生存率增加有关。本研究的目的是在更大的严重脓毒症患者队列（n=196）中增加预测准确性并控制更多混杂变量，以确认 mtDNA 单倍群 JT 是否影响这些患者的短期和中期生存率。
方法
我们在西班牙的 6 个重症监护病房进行了一项前瞻性、多中心、观察性研究。我们在第二队列的 196 名患者和全球队列（第一和第二队列合并）的 292 名严重脓毒症患者中确定了 30 天和 6 个月的生存率和 mtDNA 单倍群。使用多变量逻辑回归和 Cox 回归分析来检验 mtDNA 单倍群 JT 与 30 天和 6 个月生存率的关联，同时控制年龄、性别、血清白细胞介素-6 水平和 SOFA 评分。
结果
多变量逻辑回归和 Cox 回归分析显示，第一队列（n=96）中 mtDNA 单倍群 JT 与其他单倍群的患者在 30 天和 6 个月生存率上无差异。在第二队列（n=196）中，这些分析显示单倍群 JT 的患者在 30 天和 6 个月生存率上有较高的趋势。在全球队列（n=292）中，多变量逻辑回归和 Cox 回归分析显示单倍群 JT 的患者 30 天和 6 个月生存率更高。在 30 天和 6 个月生存率方面，J 和 T 亚单倍群之间没有显著差异。
结论
这项全球队列研究（第一和第二队列合并）是迄今为止报道脓毒症患者 mtDNA 单倍群的最大研究，证实了单倍群 JT 的患者显示出 30 天和 6 个月生存率的增加。这一发现可能是由于定义整个单倍群 JT 的单核苷酸多态性，而不是分别针对 J 或 T 亚单倍群。
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