Correlation Between Clinical Phenotype Characteristics And Tumor Necrosis Factor-?-308 Gene Polymorphism In Chronic Obstructive Pulmonary Emphysema

Objectives By observing the clinical characteristics of patients with chronic obstructive pulmonary disease(COPD)emphysema,the general clinical features and changes in the characteristics of inflammatory markers.To investigate the relationship between TNF-?-308 gene polymorphisms and the clinical phenotype of patients with emphysema,and the clinical value of the genotypic distribution of this locus in the "precise typing" of the clinical phenotype of COPD.Methods 1 Subjects A total of 120 Han patients with COPD were selected from admitted the Department of Respiratory Medicine,Affiliated Hospital of North China University of Science and Technology between October 2015 and April 2017.According to the literature standards,the emphysema scores were improved by diagnostic imaging physicians,and emphysema was defined based on the scores.Phenotypical and nonemphysema phenotype COPD,60 cases of emphysema phenotype COPD(experimental group),non-emphysema phenotype COPD 60 cases(control group).2 Research methods The subjects' age,gender,body mass index(BMI),smoking index,disease course,and family oxygen therapy were collected.Admission to improve high-resolution chest CT,pulmonary function tests,blood gas analysis(ABG)exhaled nitric oxide(FeNO).The levels of plasma periostin,TNF-? and ET-1 were measured by enzyme linked immunosorbent assay(ELISA).Whole blood DNA was extracted according to the instructions in the kit.The amplified products were detected by electrophoresis.PCR products were sequenced by direct sequencing to detect the genotype and allele frequencies of the TNF-?-308 locus.SPSS17.0 statistical software was used to analyze the data and chromatogram software was used to read the peak map.P<0.05 was considered statistically significant.Results 1(1)There was no significant difference in the gender composition ratio,age,BMI,smoking index,disease course,and family oxygen therapy between the case group and the control group(P>0.05).(2)There was no significant difference in the FEV1/FVC,FEV1% pred,and PaO2,PaCO2 in the lung function test between the case group and the control group(P>0.05).(3)Comparison of lung function and blood gas analysis between subgroup 1-2 and subgroup 3-4 of the case group.FEV1% pred was even more severe in subgroups 3-4(P<0.05).Blood gas analysis showed that PaO2 was lower and PaCO2 retention was heavier in subgroups 3-4(P<0.05).2(1)Comparison of Plasma Inflammation Markers: Through comparison of plasma TNF-?,Periostin,and ET-1 between the two groups,the levels of plasma periostin and TNF-? in the case group were significantly higher than those in the control group.Significance(P<0.05),ET-1 levels were not statistically different between the two groups(P>0.05).(2)Comparison of exhaled nitric oxide levels: FeNO levels were higher in the case group than in the control group by comparing FeNO levels between the two groups(P<0.05).3 TNF-?-308 gene locus genotype and allele detection results:(1)Detection of TNF-?-308 genotypes by direct sequencing of PCR amplification products in both groups G/G can be detected in each group,A/G and A/A type.The HardyWeinberg balance test for both groups was in accordance with the law of heritage balance(P>0.05).(2)Logistics regression analysis: After Logistic regression analysis,it was shown that the A allele and the emphysema phenotype COPD were susceptible;through comparison of the genotypes of patients with emphysema phenotype COPD,the A/G,A/A genotype and lung gas were found.Patients with phenotypic COPD are closely related.Multivariate logistic regression analysis revealed that the tumor necrosis factor-?-308 genotypes A/G and A/A were associated with the development of COPD in the phenotype of COPD.and the A/G type was related to the severity of emphysema.Conclusions 1)Emphysema clinical phenotypic characteristics COPD is Unlike nonimmune Emphysema phenotypic COPD patients with inflammatory markers,TNF-?,Periostin,FeNO increased significantly in patients with emphysema phenotype COPD.2)The TNF-?-308 gene A allele is associated with the emphysema phenotype COPD.Genotype A/G and A/A COPD patients are associated with the clinical phenotype susceptibility of emphysema,of which A/G type associated with the severity of emphysema.