TNF-α基因多态性及分泌性中耳炎关联.doc

TNF-α基因多态性及分泌性中耳炎关联 　 作者：谭慧欢，黄海玲，解继胜，赵琼芝 【摘要】 目的 探讨TNF-α基因启动子-238G/A多态性与分泌性中耳炎（SOM）的相关关系。方法 应用聚合酶链反应-限制性片段长度多态性法（PCR-RFLP）检测125例SOM患者和130例健康对照者TNF-α基因启动子-238G/A多态性。结果 TNF-α-238基因型GG、GA频率在对照组和SOM组分别为93.85%，6.15%和85.60%，14.40%；等位基因G、A频率在对照组和SOM组分别为96.92%，3.08%和92.80%，7.20%。两组差异均有显著性（Plt;0.05），携带GA基因型个体患SOM的风险约是GG基因型的2.565倍(OR=2.565，95%CI=1.072～6.138)。结论 TNF-α-238基因多态性与SOM的发病有相关性，A等位基因可能是SOM的遗传易感基因。 【关键词】 肿瘤坏死因子-α；基因多态性；中耳炎，伴渗出液 Abstract: Objective To examine the association between polymorphism of tumor necrosis factor-alpha (TNF-alpha)-238 G/A promoter with secretory otitis media (SOM). Methods The polymorphism of TNF-alpha was detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methods in 125 patients with SOM and 130 healthy controls. Results TNF-alpha genotype frequencies of GG, GA were 93.85%, 6.15% and 85.60%, 14.40% in SOM group and control group, respectively. Allele frequencies of G, A were 96.92%, 3.08% and 92.80%, 7.20% in SOM group and control group, respectively. There was statistically significant difference in frequencies of allele and genotype in TNF-alpha polymorphism between SOM group and control group (Plt;0.05). The relative risk suffered from SOM in patients with GA genotype was as 2.565 times as those with GG genotype (OR=2.565, 95%CI=1.072～6.138). Conclusion TNF-alpha-238 polymorphism is positively associated with the genesis of SOM, and A allele maybe a risk factor for SOM. Key words: tumor necrosis factor-alpha; gene polymorphism; otitis media with effusion 　　分泌性中耳炎(secretory otitis media,SOM)是以中耳积液及听力下降为主要特征的中耳非化脓性炎性疾病，小儿的发病率比成人高，是引起小儿听力下降的重要原因之一。目前SOM发病确切机理尚未完全明了，近年国内外的研究［1］表明免疫反应与SOM的发病关系密切，其中肿瘤坏死因子-α(tumor necrosis factor alpha,TNF-α)在SOM免疫反应中的作用日益被耳科学者重视，已成为研究SOM发病机理的活跃领域。有研究证实［2］，TNF-α基因多态性与多种疾病相关，但TNF-α基因多态性与SOM是否关联，目前尚不清楚，为此，我们采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)方法，探讨TNF-α基因多态性与SOM的关系，为揭示SOM的发病机理提供一定的实验依据和新的视角。 　　1 对象与方法 　　1.1 研究对象 　　SOM组：经纯音测听、声导抗测试、鼓膜穿刺等检查确诊为SOM患儿(排除鼻咽部疾病者)125例，男68例，女57例，年龄3～16岁，平均