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甘露糖结合凝集素基因多态性及其对早产儿近期结局的影响。

Mannose-binding lectin gene polymorphism and its effect on short term outcomes in preterm infants.

机构信息

Uludag University, Faculty of Medicine, Department of Pediatrics, Bursa, Turkey.

Uludag University, Faculty of Medicine, Department of Pediatrics, Bursa, Turkey.

出版信息

J Pediatr (Rio J). 2020 Jul-Aug;96(4):520-526. doi: 10.1016/j.jped.2019.03.001. Epub 2019 Apr 26.

Abstract

OBJECTIVE

Mannose-binding lectin, which belongs to the collectin family, is an acute-phase reactant that activates the complement system. This study aimed to investigate the effect of MBL2 gene polymorphism on short-term outcomes in preterm infants.

METHOD

Infants of <37 gestational weeks who were admitted to the neonatal intensive care unit during a two-year period were enrolled in this prospective study. The neonates were categorized into two groups according to their MBL2 genotypes. Normal MBL2 genotype was defined as MBL2 wild-type (AA genotype), whereas mutant MBL2 genotype was defined as MBL2 variant-type (AO/OO genotype). The relationship between MBL2 genotype and short-term morbidity and mortality was evaluated.

RESULTS

During the two-year study period, 116 preterm infants were enrolled in this study. In MBL2 variant-type, mannose-binding lectin levels were significantly lower and incidences of mannose-binding lectin deficiency (MBL level<700ng/mL) were higher (p<0.001). In this group, the prevalence of respiratory distress syndrome and mortality was significantly higher (p<0.001, p=0.03 respectively). In the MBL2 wild-type group, the prevalence of necrotizing enterocolitis (NEC) was higher (p=0.01). Logistic regression analyses revealed that MBL2 variant-type had a significant effect on respiratory distress syndrome development (odds ratio, 5.1; 95% confidence interval, 2.2-11.9; p<0.001).

CONCLUSIONS

MBL2 variant-type and mannose-binding lectin deficiency are important risk factors for respiratory distress syndrome development in preterm infants. Additionally, there is an association between MBL2 wild-type and NEC. Further studies on this subject are needed.

摘要

目的

甘露聚糖结合凝集素属于凝集素家族,是一种急性期反应物,可激活补体系统。本研究旨在探讨甘露聚糖结合凝集素 2 基因多态性对早产儿短期结局的影响。

方法

本前瞻性研究纳入了在两年期间入住新生儿重症监护病房的<37 孕周的婴儿。根据 MBL2 基因型将新生儿分为两组。正常 MBL2 基因型定义为 MBL2 野生型(AA 基因型),而突变 MBL2 基因型定义为 MBL2 变异型(AO/OO 基因型)。评估 MBL2 基因型与短期发病率和死亡率之间的关系。

结果

在两年的研究期间,共有 116 例早产儿纳入本研究。在 MBL2 变异型中,甘露聚糖结合凝集素水平显著降低,甘露聚糖结合凝集素缺乏症(MBL 水平<700ng/mL)的发生率更高(p<0.001)。在该组中,呼吸窘迫综合征和死亡率的患病率显著更高(p<0.001,p=0.03)。在 MBL2 野生型组中,坏死性小肠结肠炎(NEC)的患病率更高(p=0.01)。Logistic 回归分析显示,MBL2 变异型对呼吸窘迫综合征的发展有显著影响(比值比,5.1;95%置信区间,2.2-11.9;p<0.001)。

结论

MBL2 变异型和甘露聚糖结合凝集素缺乏是早产儿呼吸窘迫综合征发展的重要危险因素。此外,MBL2 野生型与 NEC 之间存在关联。需要对此主题进行进一步的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49c0/9432184/699bab1ea69e/gr1.jpg

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