Abstract:Objective: To explore the correlation between Th1/Th2 balance, human leukocyte antigen DQA1 (HLA-DQA1) gene polymorphism, and catheter-related infections during hemodialysis.Methods: Forty-eight patients with hemodialysis catheter-related infections treated at our hospital from January 2020 to January 2024 were selected as the observation group. Two hundred sixty patients undergoing hemodialysis without catheter-related infections during the same period were selected as the control group. The differences in Th1 cells, Th2 cells, associated cytokines, and HLA-DQA1 gene polymorphisms between the two groups were compared.Results: The Th1, Th2, TNF-α, TGF-1, IL-4, and IL-6 levels in the observation group were (43.35±9.10)%, (3.10±0.92)%, (46.22±8.87) pg/mL, (50.05±13.36) pg/mL, (1.03±0.35) pg/mL, and (40.05±11.65) pg/mL, respectively, higher than those in the control group (P<0.05), while Th1/Th2 levels were (14.01±2.20), lower than those in the control group (P<0.05). There was a statistically significant difference in HLA-DQA1 genotype between the observation group and the control group (P<0.05). The TNF-α, IL-4, and IL-6 of the observation group's deceased patients were (58.07±2.65) pg/mL, (1.22±0.21) pg/mL, and (46.67±9.96) ng/L, respectively, higher than those of the surviving patients (P<0.05). There was no statistically significant difference in HLA-DQA1 gene polymorphism between surviving and deceased patients in the observation group (P>0.05).Conclusion: Patients with hemodialysis catheter-related infections exhibit elevated levels of Th1 cells, Th2 cells, and associated factors. There are differences in HLA-DQA1 genotypes between patients with and without infections, with TNF-α, IL-4, and IL-6 levels associated with prognosis.
何帆, 杨文君, 马丽, 韩媛媛. Th1/Th2平衡及HLA-DQA1基因多态性与血液透析导管性感染的相关性[J]. 河北医学, 2024, 30(8): 1336-1340.
HE Fan, YANG Wenjun, MA Li, et al. Correlation of Th1/Th2 Balance and HLA-DQA1 Gene Polymorphism with Hemodialysis Catheter-Related Infections. HeBei Med, 2024, 30(8): 1336-1340.
[1] Agarwal AK,Roy-Chaudhury P,Mounts P,et al.Taurolidine/heparin lock solution and catheter-related bloodstream infection in hemodialysis:a randomized,double-Blind,active-control,phase 3 study[J].Clin Am Soc Nephrol,2023,18(11):1446-1455. [2] Wang Y,Sun X.Reevaluation of lock solutions for central venous catheters in hemodialysis:a narrative review[J].Ren Fail,2022,44(1):1501-1518. [3] Iguidbashian J,Imran R,Yi JA.Maintenance and salvage of hemodialysis access[J].Surg Clin North Am,2023,103(4):685-701. [4] Acquier M,De Precigout V,Delmas Y,et al.Diagnostic et prise en charge des bacteremies liees au catheter d'hemodialyse:10 ans apres les dernieres recommandations[J].Nephrol Ther,2022,18(2):80-88. [5] Almeida BM,Moreno DH,Vasconcelos V,et al.Interventions for treating catheter-related bloodstream infections in people receiving maintenance haemodialysis[J].Cochrane Database Syst Rev,2022,4(4):e13554. [6] Chen X,Liang M.A Meta-analysis of incidence of catheter-related bloodstream infection with midline catheters and peripherally inserted central catheters[J].Healthc Eng,2022,2022(8):6383777. [7] 中华人民共和国卫生部.医院感染诊断标准(试行)[J].中华医学杂志,2001. [8] Hussein WF,Gomez N,Sun SJ,et al.Use of a gentamicin-citrate lock leads to lower catheter-related bloodstream infection rates and reduced cost of care in hemodialysis patients[J].Hemodial Int,2021,25(1):20-28. [9] Hajji M,Neji M,Agrebi S,et al.Incidence and challenges in management of hemodialysis catheter-related infections[J].Sci Rep,2022,12(1):e20536. [10] 车旭,乔东鸽,庞欣欣,等.血液透析导管相关性感染的危险因素及防治研究进展[J].国际泌尿系统杂志,2023,43(3):575-578. [11] Almenara-Tejederas M,Rodriguez-Perez MA,Moyano-Franco MJ,et al.Tunneled catheter-related bacteremia in hemodialysis patients:incidence,risk factors and outcomes.A 14-year observational study[J].Nephrol,2023,36(1):203-212. [12] Susilo A,Suryana KD,Nugroho P,et al.Risk factors for temporary vascular access infection in patients with end-stage renal disease undergoing hemodialysis in cipto mangunkusumo hospital[J].Acta Med Indones,2022,54(3):356-364. [13] Wang L,Jia L,Jiang A.Pathology of catheter-related complications:what we need to know and what should be discovered[J].Int Med Res,2022,50(10):e890. [14] 周菊梅,雷斐,杜文渊.HLA-DQ基因多态性与孕妇泌尿生殖道沙眼衣原体感染的关联及其对母婴结局的影响[J].中华医院感染学杂志,2023,33(3):448-452.