小儿肾病综合症肾素-血管紧张素系统基因多态性研究

Study on gene polymorphism of renin angiotensin system in children with nephritic syndrome

目的:探讨肾素-血管紧张素系统基因多态性与小儿肾脏疾病的关系及其意义。方法:用PCR方法检测4 0例肾病综合症患儿及5 0例正常对照组儿童的肾素-血管紧张素系统基因多态性。结果:①血管紧张素M2 35T基因多态性MM、MT、TT基因型肾病组分别为37 5 %、2 7 5 %、35 0 % ;对照组分别为6 6 0 %、18 0 %、16 0 % ,差异有显著性(P <0 0 5 )。②血管紧张素Ⅱ受体Ⅰ基因多态性AA、AC、CC基因型肾病组分别为4 5 0 %、2 7 5 %、2 7 5 % ,对照组分别为6 8 0 %、2 0 0 %、12 0 % ,差异无显著性(P >0 0 5 )。③血管紧张素转换酶基因多态性Ⅱ、DI、DD基因型肾病组分别为4 5 0 %、4 2 5 %、12 5 % ,对照组分别为4 6 0 %、4 4 0 %、10 0 % ,差异无显著性(P >0 0 5 )。其中难治性肾病组(2 0例)与非难治性肾病组(2 0例)比较、激素敏感组(2 9例)与激素耐药组(11例)比较,血管紧张素M2 35T基因多态性、血管紧张素Ⅱ受体Ⅰ基因多态性、血管紧张素转换酶基因多态性差异均无显著性(均P >0 0 5 )。结论:血管紧张素M2 35T基因TT型可能与小儿肾病综合症的发病密切相关;血管紧张素Ⅱ受体Ⅰ基因多态性、血管紧张素转换酶基因多态性与小儿肾病综合症的发病无关。

Aim: In order to determine whether nephritic syndrome in children associated with difference genotype of renin angiotensin system (RAS). Methods: Three RAS genotypes were examined in 40 children with nephritic syndrome and in 50 children of health control group. Results: ①The frequency of the gene polymorphisms of M235T angiotensinogen gene: In the nephritic syndrome group, the frequency of MM, MT, TT genotype were 37.5%, 27.5%, 35.0% respectively, and in the control group, the frequency of MM? MT? TT genotype were 66.0%, 18.0%, 16.0% respectively; there are statistic difference between the two groups (P<0.05). ②The frequency of the gene polymorphisms of angiotensin Ⅱ receptor type Ⅰ gene: In the nephritic syndrome group, the frequency of AA, AC, CC genotype were 45.0%, 27.5%, 27.5% respectively. In the control group, the frequency of AA, AC, CC genotype were 68.0%, 20.0%, 12.0% respectively; there was no statistic difference between the two groups (P>0.05). ③The frequency of the gene polymorphisms of the angiotensin-converting enzyme (ACE) gene: In the nephritic syndrome group, the frequency of Ⅱ, DI, DD genotype were 45.0%, 42.5%, 12.5% respectively, and in the control group, the frequency of Ⅱ, DI, DD genotype were 46.0%, 44.0%, 10.0% respectively; there was no statistic difference between the two groups (P>0.05); There were no differences between 20 patients in difficult treatment groups (steroid resistant or steroid dependency or frequently relapsing nephritic syndrome) and 20 patients in not difficult treatment group (steroid sensitive and not frequently relapsing nephritic syndrome) and between 29 patients in steroid sensitive groups and 11 patients in steroid resistant group (P>0.05). Conclusion: TT genotype of M235T angiotensinogen gene may be associated with the pathogenesis of nephritic syndrome in children. The frequency of the gene polymorphisms of angiotensin Ⅱ receptor type Ⅰ gene and angiotensin-converting enzyme (ACE) gene are not associated with the pathogenesis of nephritic syndrome in children. The difference genotype of rennin angiotensin system related with the result of the treatment of the children with nephritic syndrome can not be demostrated.