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目的 探讨IRAK4(interleukin-1 receptor-associated kinase 4,IRAK4)基因单核苷酸多态性(single nucleotide polymorphisms,SNPs)与中国汉族人群严重脓毒症易感性和预后的相关性.方法 收集2006年2月至2009年12月复旦大学附属中山医院急诊科收治的192例严重脓毒症患者进行研究.排除既往患有自身免疫性疾病、正在应用免疫抑制剂、AIDS和肿瘤患者.另外选择年龄和性别匹配的192名健康个体作为对照.本研究获得复旦大学附属中山医院伦理委员会同意.严重脓毒症患者根据30 d是否存活分为存活组和死亡组,存活组124例,死亡组68例.利用Hapmap中国人群数据库选择标签SNPs(tagSNPs),利用Primer 3软件设计引物；采用DNA抽提试剂盒提取外周血DNA,PCR-直接测序法进行SNPs分型.基因型频率和等位基因频率在各组之间的比较采用x2检验.结果 IRAK4基因7个tagSNPs等位基因频率分布在研究样本中均符合Hardy-Weinberg平衡.研究发现位于IRAK4基因外显子的SNP rs4251545(G/A)等位基因和基因型频率在严重脓毒症组和健康对照组之间差异具有统计学意义(等位基因P=0.015,基因型P=0.035),携带等位基因A的个体比携带等位基因G的个体更易患严重脓毒症(OR=1.69,95％ CI:1.10～2.58);7个tagSNPs的等位基因和基因型频率在死亡组和存活组中差异无统计学意义.结论IRAK4基因变异与中国汉族人群严重脓毒症易感性有关.“,”Objective To investigate the possible association of IRAK4 polymorphisms with susceptibility to and prognosis of severe sepsis.Methods A total of 192 patients hospitalized in emergency department of Zhongshan Hospital from February 2006 to December 2009,and another 192 healthy volunteers were enrolled in this case-control study.Patients were excluded if they had metastatic tumors,autoimmune diseases,AIDS or received immunosuppressive drugs.This study was approved by the ethical committee of Zhongshan Hospital,Fudan University.Sepsis patients were divided into survival group(n =124)and non-survival group(n =68)according to the 30-day mortality.Primer 3 software was used to design the PCR and sequencing primers.Genomic DNA was extracted from peripheral blood mononuclear cells.Seven tagSNPs were selected based on the data of Chinese Han in Beijing from the Hapmap projectand genotyped by direct sequencing.We used x2 analysis to evaluate the significance of differences in genotype and allele frequencies between different groups.Results The distributions of all tagSNPs were consistent with Hardy-Weinberg equilibrium.The allele and genotype frequencies of rs4251545(G/A)were significantly different between severe sepsis and healthy control groups(P =0.015,P =0.035,respectively).Carriers of the rs4251545A had a higher risk for severe sepsis compared with carriers of the rs4251545G(OR =1.69,95％ CI:1.10-2.58).The allele and genotype frequencies of all SNPs were not significantly different between survivor group and non-survivor group.Conclusions These findings indicated that the variants in IRAK4 are significantly associated with severe sepsis susceptibility in the Chinese Han population.