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目的探讨肺表面蛋白A(SPA)和肺表面蛋白B(SPB)基因多态性与支气管肺发育不良(BPD)的相关性。方法运用PCR-限制性片段长度多态性(RFLP)和基因测序方法检测BPD组(51例)和对照组(103例)新生儿的SPA1AA50G/C、SPA1AA219C/T、SPB-18A/C、SPB1580C/T基因型频率和等位基因频率。结合临床参数,运用χ2检验、Fisher’s精确概率法及多因素Lo-gistic回归分析统计学方法分析与BPD发病有关的危险因素。结果 SPA1AA219C/T和SPB1580C/T等位基因和基因型频率在BPD组和对照组中比较差异无统计学意义,而SPA1AA50等位基因G、基因型GG和GC及SPB-18等位基因A、基因型AA和AC分布频率在BPD组中明显高于对照组,差异均有统计学意义(Pa<0.05)。临床参数中,BPD组出生体质量、胎龄、经鼻持续正压通气(CPAP)、机械通气、出生后应用地塞米松、颅内出血和PDA与对照组比较差异均有统计学意义(Pa<0.05)。多因素Logistic回归分析显示,BPD与CPAP、出生后应用地塞米松、颅内出血、SPA1AA50基因型GG和GC及SPB-18基因型AA、AC无关,而与机械通气和PDA呈正相关,与出生体质量、胎龄呈负相关。结论 SPA1AA50G/C、SPB-18A/C不是BPD发病的遗传易感基因。机械通气和PDA是BPD的高危因素,出生体质量和胎龄是其保护因素。
Objective To investigate the association between pulmonary surfactant protein A (SP) and lung surface protein B (SPB) gene polymorphism and bronchopulmonary dysplasia (BPD). Methods SPA1AA50G / C, SPA1AA219C / T, SPB-18A / C and SPB1580C were detected in neonates with BPD and control group by PCR-RFLP and gene sequencing methods. / T genotype frequency and allele frequency. Combined with clinical parameters, using χ2 test, Fisher’s exact test and multi-factor Lo-gistic regression analysis of statistical methods to analyze the risk factors associated with BPD. Results The frequencies of alleles and genotypes of SPA1AA219C / T and SPB1580C / T were not significantly different between BPD group and control group. However, SPA1AA50 allele G, genotype GG and GC and SPB-18 allele A, The frequencies of AA and AC genotypes in BPD group were significantly higher than those in control group (P <0.05). Among the clinical parameters, the birth weight, gestational age, CPAP, mechanical ventilation, dexamethasone after birth, intracranial hemorrhage and PDA in the BPD group were significantly different from those in the control group (Pa < 0.05). Multivariate logistic regression analysis showed that BPD and CPAP, dexamethasone after birth, intracranial hemorrhage, SPA1AA50 genotype GG and GC and SPB-18 genotype AA, AC has nothing to do with the mechanical ventilation and PDA was positively correlated with the birth Quality, gestational age was negatively correlated. Conclusion SPA1AA50G / C and SPB-18A / C are not genetically susceptible genes of BPD. Mechanical ventilation and PDA are risk factors for BPD. Birth weight and gestational age are the protective factors.