Outcome prediction in sepsis combined use of genetic polymorphisms - A study in Japanese population
Outcome prediction in sepsis combined use of genetic polymorphisms - A study in Japanese population
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DOI：
10.1016/j.cyto.2010.12.001
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发表时间：
2011-04-01
期刊：
影响因子：
3.8
通讯作者：
Uno, Hajime
中科院分区：
文献类型：
--
作者：
Shimada, Tadanaga;Oda, Shigeto;Uno, Hajime
最近发现基因多态性与脓毒症患者的临床结局相关。本研究旨在评估日本脓毒症患者遗传多态性对临床结局的影响，以及是否使用遗传多态性作为预测因子能够更准确地预测结局。通过多变量logistic回归分析，研究了2001年10月至2007年11月入住ICU的脓毒症患者（n = 123）中与促炎介质相关的16种基因多态性和常规人口统计学/临床参数（年龄、性别、既往病史和APACHE II评分）对ICU死亡率以及ICU住院期间疾病严重程度的影响。ICU死亡率与TNF-308 GA、IL-1 β-31 CT/TT和APACHE II评分显著相关。受试者操作特征（ROC）分析表明，与单独的APACHE II评分（ROC-AUC = 0.68）相比，使用APACHE II评分和两个遗传参数（TNF-308和IL 1 β-31）能够更准确地预测ICU死亡率（ROC-AUC = 0.80）。在脓毒症患者中观察到TNF-308和IL-1 β-31两种基因多态性与ICU死亡率显著相关。此外，将这些遗传参数与APACHE II评分结合使用，可以更准确地预测脓毒症患者的预后。(C)2010爱思唯尔有限公司版权所有。
Genetic polymorphisms have recently been found to be related to clinical outcome in septic patients. The present study investigated to evaluate the influence of genetic polymorphisms in Japanese septic patients on clinical outcome and whether use of genetic polymorphisms as predictors would enable more accurate prediction of outcome. Effects of 16 genetic polymorphisms related to pro-inflammatory mediators and conventional demographic/clinical parameters (age, sex, past medical history, and APACHE II score) on ICU mortality as well as disease severity during ICU stay were examined in the septic patients (n = 123) admitted to the ICU between October 2001 and November 2007 by multivariable logistic regression analysis. ICU mortality was significantly associated with TNF -308GA, IL1 beta -31CT/TT, and APACHE II score. Receiver-operating characteristics (ROC) analysis demonstrated that, compared with APACHE II score alone (ROC-AUC = 0.68), use of APACHE II score and two genetic parameters (TNF -308 and IL1 beta -31) enabled more accurate prediction of ICU mortality (ROC-AUC = 0.80). Significant association of two genetic polymorphisms, TNF -308 and IL1 beta -31, with ICU mortality was observed in septic patients. In addition, combined use of these genetic parameters with APACHE II score may enable more accurate prediction of outcome in septic patients. (C) 2010 Elsevier Ltd All rights reserved.