Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: 4G/5G polymorphism of PAI-1 gene is associated with multiple organ dysfunction and septic shock in pneumonia induced severe sepsis: prospective, observational, genetic study. | Madách et al. Critical Care 2010 14 R79 http content 14 2 R79 c CRITICAL CARE RESEARCH Open Access 4GpG polymorphism of PAI-1 gene is associated with multiple organ dysfunction and septic shock in pneumonia induced severe sepsis prospective observational genetic study Krisztina Madách 21 István Aladzsityf2 Ágnes Szilágyi2 3 George Fust2 János Gál 1 István Penzes1 and Zoltán Prohászka2 3 Abstract Introduction Activation of inflammation and coagulation are closely related and mutually interdependent in sepsis. The acute-phase protein plasminogen activator inhibitor-1 PAI-1 is a key element in the inhibition of fibrinolysis. Elevated levels of PAI-1 have been related to worse outcome in pneumonia. We aimed to evaluate the effect of functionally relevant 4G 5G polymorphism of PAI-1 gene in pneumonia induced sepsis. Methods We enrolled 208 Caucasian patients with severe sepsis due to pneumonia admitted to an intensive care unit ICU . Patients were followed up until ICU discharge or death. Clinical data were collected prospectively and the PAI-1 4G 5G polymorphism was genotyped by polymerase chain reaction-restriction fragment length polymorphism technique. Patients were stratified according to the occurrence of multiple organ dysfunction syndrome septic shock or death. Results We found that carriers of the PAI-1 4G 4G and 4G 5G genotypes have a higher risk for multiple organ dysfunction syndrome odds ratio OR 95 confidence interval CI - p and a higher risk for septic shock OR 95 CI - p than 5G 5G carriers. The multivariate logistic regression analysis adjusted for independent predictors such as age nosocomial pneumonia and positive microbiological culture also supported that carriers of the 4G allele have a higher prevalence of multiple organ dysfunction syndrome adjusted odds ratio aOR 95 CI p and septic shock aOR 95 CI p . However genotype and allele .
