TNF2の関連性,TNF-αプロモーターポリモルフィズム,セプティックショック感受性および死亡率:マルチセンター研究
1Intensive Care Unit, Cochin Port-Royal University Hospital, Paris, France.
JAMA
|August 18, 1999
まとめ
TNF2アレルは, септикショックに対する感受性の増加と,この重症感染症による死亡リスクの上昇と関連しています. この遺伝的要因は,患者のアウトカムに重要な役割を果たします.
科学分野:
- 免疫遺伝学 免疫遺伝学
- クリティカルケア・メディシン
- 分子生物学は分子生物学である.
背景:
- 腫瘍死滅因子アルファ (TNF-alpha) は,セプティックショック病原性における重要なサイトカインである.
- TNF-α遺伝子プロモーターのTNF2ポリモルフィズムは,TNF-αの産生の増加と,感染症におけるより悪い結果と関連しています.
研究 の 目的:
- セプティックショック患者におけるTNF2アレルの頻度を測定する.
- TNF2アレルとセプティックショックの発生と死亡率との関連性を評価する.
主な方法:
- 89人のセプティックショック患者と87人の健康な対照群を対象に,多センター症例対照研究が行われました.
- TNF2アレル頻度はグループ間で比較され,TNF-α濃度が測定されました.
- 年齢と簡略化された急性生理学スコア (SAPS II) により制御されたロジスティック回帰分析.
主要な成果:
- セプティックショック患者は,対照群と比較して,TNF2アレル頻度 (39%) が高かった (18%).
- TNF2アルレルは,セプティックショックの生存者 (24%) よりも,非生存者 (52%) でより一般的でした.
- TNF2アレルを持つ患者は,SAPS IIスコアとは無関係に,死亡のリスクが3.7倍増加しました.
結論:
- TNF2アレルは, сепティックショックの発症の感受性と強く関連しています.
- TNF2アレルは,結血性ショック患者における死亡リスクの重要な要因である.
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