儿童流感的临床特征分析和Toll样受体3基因多态性与儿童流感遗传(2)

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万方数据

英文摘要

which resulted in changes of TLR3 receptor extracellular domain and affect Toll-like receptor signaling and generation of inflammatory mediators , so that the body become more susceptible to the flu virus.Although these studies have shown that TLR3 gene polymorphism associated with the susceptibility and severity of influenza , there is not such research in China . From the perspective of single nucleotide polymorphism, this research aimed to explore the relationship between TLR3 genetic polymorphisms and susceptibility , severity of influenza in children through detecting TLR3 genetic polymorphism.

Objective：

1.Review and analyze the clinical information of 86 influenza children that admitted

to Guangzhou Women and Children’s Medical Center between 2013.3 and 2013.5.

2.Detect the polymorphisms of TLR3 gene in these 86 cases , to preliminarily

investigate the correlation of TLR3 SNPs polymorphism and the genetic susceptibility and severity in children of Han Chinese with influenza.

Methods:

Consult the medical recods of 86 in-hospital patients who had been Diagnosed of influenza A or influenza B in Guangzhou Women and Children’s medical Center between 2013.3 to 2013.5, analyze the clinical features of these cases. Use gene-sequencing method to resequence the TLR3 gene for SNPs,and the selected polymorphisms were compared to 197 Chinese individuals from 1000 Genomes Project Database. Gene counting method was used to calculate the frequencies of allele and genotype among the mild group, the critical group and the severe group,while Chi-square test was used to analyzing the difference of allele and genotype distribution among these groups.Calculating the odds ratio and 95% confidence intervals to assess the risk of alleles and genotypes.T-test was used to compare the data ,P<0.05 was considered statistically significant.

Results:

1.86 children of influenza , the mild group were 43 cases , the severe group were 43

cases, the average age of the mild group was 4.58±2.69 years old, the severe group was

2.43±1.83 years old (P <0.05), the average hospitalization of the mild group was 5.05 ±

2.50 days, significantly shorter than the severe group 1

3.86±11.25 days (P <0.05),there

were 16 children in the severe group stayed in PICU for 9.67±7.89 days. PRISM Ⅲ scores of the severe group was 9.44±3.29, PRISM Ⅲ scores of 16 cases of PICU stay within 24

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万方数据

广州医科大学硕士学位论文

hours of admission was 5.21±3.95 ; PaO2/FiO2 was 261.16±76.95 in the severe group , PaO2/FiO2 of 16 cases of PICU stay within 24 hours of admission was 191.69±66.9; chest radiography showed incidence of infiltrates in bilateral pulmonary was 58.1% in the severe group; In the severe group ,the incidence of respiratory dysfunction was 34.9%, the number of days of mechanical ventilation was 6.15±4.81 days; the incidence of liver dysfunction was 16.3% ; the incidence of neurological dysfunction was 16.3%, there were

2 cases with coagulation system dysfunction, 2 cases with circulatory dysfunction, and 2

cases died .

2.TLR3 gene SNPs were compared between Han Chinese and European, Han

Chinese and African between the groups, the frequencies of alleles and genotype of the SNPs were statistically significant (P <0.05).

3.The allele T and G frequencies of TLR3 gene rs1879026 in Han Chinese were

79.4% and 20.6%, in the case group were 75.0% and 25.0%, frequency of allele T in case

group was significantly higher than Han Chinese ,there was significantly different in the two groups (P = 0.039 <0.05), OR value was 1.539, 95% CI = (1.020-2.323). the frequencies of alleles and genotype of rs1879026 were compared between the mild group and the severe group，there was no statistically significant difference(P>0.05).

4．The frequencies of alleles and genotype of rs5743312、rs5743313、rs5743314 were compared between the case group and Han Chinese ,the mild group and the severe group，there was no statistically significant difference(P>0.05).

5.The study found there was a haplotypes block in TLR3 gene which composed of

three SNPs (rs1879026, rs5743313, rs5743314), and a total of four haplotypes such as GCG, TCG, GTC and GTG, there was no statistically significant difference in these four haplotypes compared between the case group and Han Chinese , the mild group and the severe group as well (P> 0.05).

6.Test of Hardy-Weinberg equilibrium showed expectations and observations of

genotype are in good agreement and a good group representation between the case group and Han Chinese.

Conclusions:

6 万方数据

英文摘要

pared with the mild group, the severe group were commonly under 3 years old.

Laboratory tests(PaO2／FiO2)，imaging examination，PRISMIII score and assessment of organ dysfunction are helpful for severity and prognosis judgment．

2.TLR3 gene rs1879026 T allele was related to the susceptibility but not the severity

of influenza in children.

3.TLR3 gene rs5743312、s5743313、rs5743314 polymorphisms were not related to

susceptibility and severity of influenza in children.

4.The study found that there were a haplotypes block composed of three SNPs in

TLR3 gene, including four haplotypes which were not related to susceptibility and severity of influenza in children.

Keywords: Toll-like receptor 3 ;Genetic polymorphism; Children; Influenza; Clinical

analysis

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广州医科大学硕士学位论文

主要英文缩略词表

Abbreviation

缩写词英文全称中文全称

ARDS Acute respiratory distress syndrome 急性呼吸窘迫综合征

CI Confidence interval 置信区间

CK Creatine kinase 肌酸激酶

CK-MB Creatine kinase-MB 肌酸激酶同工酶

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