肝肾综合征与血管紧张素转换酶基因多态性的关系

To probe the relationship between hepatorenal syndrome and angitensin-converting enzyme gene polymorphism

目的 探讨失代偿性肝硬化并发肝肾综合征(HRS)与血管紧张素转换酶(ACF)基因插入/缺失(I/D)多态性之间的关系。方法 应用聚合酶链反应方法扩增76例失代偿性肝硬化并HRS患者及各对照组患者的ACE基因上的DNA片段,根据I/D来判断其多态性,同时各例均采血测谷丙转氨酶、谷草转氨酶、血清肌酐(SCr)及尿素氮(BUN)等指标,并测肾小球滤过率(GFR),比较不同基因型间这些指标的差异有无显著意义。结果 HRS患者各基因型及等位基因频率与各对照组间差异均无显著意义(P均>0.05);除其他肝病组外,各组Ⅰ等位基因频率均显著高于D等位基因频率(P均<0.01),而各对照组中,3种基因型频率间差异无显著意义(P>0.05),HRS组中,Ⅱ基因型频率显著高于ID及DD型(P<0.05)。Ⅱ基因型的BUN与SCr均显著高于ID型及DD型(P均<0.05),GFR显著低于ID型及DD型(P<0.05)。结论 ACE基因Ⅱ型可能为失代偿性肝硬化易并发HRS的遗传学方面因素。

Objective To investigate the relationship between insertion/deletion (I/D) polymorphism of ACE gene and uncompensated hepatocirrhosis with hepatorenal syndrome(HRS). Methods ACE I/D polymorphism was detected by polymerase chain reaction amplification of DNA fragment and 76 cases of uncompensated hepatocirrhosis with HRS, every group as controls were involved in this study. At the same time, GIT, GOT, serum creatinine(SCr) , blood urea nitrogen(BUN) and glomerular fdtration rate(GFR) et al of every case were measured and the significant difference of these target among different genotypes were compared. Results There was no significant difference for every genotype and allele frequency between the HRS group and every group as controls (P > 0. 05 ). The Ⅰ allele frequencies were higher than the one of D allele for every groups except other liver disease group (P < 0. 01). But in the every group as controls, there was no significant difference for the genotype frequency among three groups and in the HRS group, the Ⅱ genotype frequency was higher than the one of ID and DD (P < 0. 05). SCr and BUN of the Ⅱ genotype were higher than the one of ID and DD(P < 0. 05) and GFR of the Ⅱ genotype was lower than the one of ID and DD in the HRS group ( P < 0. 05). Conclusion There was relationship between ACE gene polymorphism and the incidence of uncompensated hepatocirrhosis with HRS.Ⅱ genotype may be the genetics factor of uncompensated hepatocirrhosis easy with HRS. The degree of kidney failure for Ⅱ genotype population was more serious than the one of ID and DD in uncompensated hepatocirrhosis with HRS.