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目的:探讨肿瘤坏死因子α(tumornecrosisfactor-α,TNF-α)-863C/A基因多态性与慢性阻塞性肺疾病(chronicobstructivepulmonary disease,COPD)间的关系。方法:采用多重聚合酶链-高温连接酶检测反应(PCR-LDR)方法研究56例吸烟COPD患者、64例吸烟正常对照组的TNF-α-863位点基因型及A等位基因的分布情况。结果:(1)吸烟COPD组在-863位点上的CA基因型及A等位基因频率均低于吸烟非COPD组(P<0.05)。(2)重度、极重度COPD组在该位点的CA基因型频率和A等位基因频率均低于轻中度COPD组(P<0.05)。在COPD组中携带A等位基因的患者有着更高的第1秒呼气量/用力肺活量(FEV1/FVC)和体重指数(BMI)(P<0.05)。(3)吸烟COPD组携带CA基因型的患者肺源性心脏病的发病率高于携带CC基因型的患者(P<0.05)。(4)吸烟COPD组的BMI[(22.0±3.1)kg/m2]较吸烟非COPD组[(24.5±3.7)kg/m2]低,重度、极重度COPD组BMI[(21.2±3.0)kg/m2]较轻中度COPD组[(23.3±3.3)kg/m2]低,差异均有统计学意义(P<0.05)。结论:TNF-α-863位点A等位基因的发生对COPD患者是一个保护性因素。低BMI与COPD关系密切,BMI可能成为预测COPD患者病情严重程度的一个重要指标。
Objective: To investigate the relationship between tumor necrosis factor α (TNF-α) -863C / A gene polymorphism and chronic obstructive pulmonary disease (COPD). Methods: The genotype and allele distribution of TNF-α-863 locus in 56 smokers with COPD and 64 smokers control group were studied by multiplex polymerase chain reaction-high temperature polymerase chain reaction (PCR-LDR) . Results: (1) The frequencies of CA genotype and A allele at -863 in smoking COPD group were lower than those in non-smoking COPD group (P <0.05). (2) The frequencies of CA genotype and A allele in severe and very severe COPD group were lower than those in mild to moderate COPD group (P <0.05). Patients who carried the A allele in the COPD group had higher 1-second FEV1 / FVC and BMI (P <0.05). (3) Smoking The incidence of pulmonary heart disease in patients with CA genotype in COPD group was higher than that in patients with CC genotype (P <0.05). (4) The BMI in the COPD group was significantly lower than that in the non-COPD group [(22.0 ± 3.1) kg / m 2 [(24.5 ± 3.7) kg / m 2 vs m2] was lower in the mild-moderate COPD group [(23.3 ± 3.3) kg / m2], the differences were statistically significant (P <0.05). Conclusion: The occurrence of TNF-α-863 A allele is a protective factor in patients with COPD. Low BMI and COPD are closely related to BMI may be an important indicator of the severity of the disease in patients with COPD.