大连地区类风湿关节炎遗传易感性与人类白细胞抗原-DRB1基因的相关性及相关因素分析

Association between the susceptibility of rheumatoid arthritis and the human leucocyte antigen-DRB1 gene and the related factors in Dalian area

目的:探讨人类白细胞抗原-DRB1基因与类风湿性关节炎遗传易感性的相关性,类风湿性关节炎患者红细胞沉降率、类风湿因子、C反应蛋白的变化与人类白细胞抗原-DRB1是否存在关联。方法:随机(隐匿分配)选择2000-02/06在大连医科大学附属第一医院住院及门诊类风湿性关节炎患者41例作为实验组。对照组为同地区的92名健康体检者。利用微量聚合酶链反应-序列特异性引物技术对人类白细胞抗原-DRB1基因进行检测;应用免疫透射比浊法对类风湿因子、C反应蛋白进行检测;应用常规魏氏法检测红细胞沉降率。结果:两组均按实验要求进入结果分析。实验组人类白细胞抗原-DRB1基因的等位基因DRB1*0405的发生频率59%明显高于正常对照组人群26%,相对危险度为4.00,而其他等位基因的发生频率在两组基本相似。而人类白细胞抗原-DRB1*0405+类风湿性关节炎患者(n=24)的类风湿因子水平明显高于人类白细胞抗原-DRB1*0405-(n=17)犤(73.4±20.3)U/mL,(14.0±7.2)U/mL,t=10.25,P<0.01犦;前者的C反应蛋白水平也明显高于后者犤(29.1±6.5)g/L,(3.2±1.5)g/L,t=5.66,P<0.01犦。结论:大连地区类风湿性关节炎患者易感基因亚型为人类白细胞抗原-DRB1*0405,类风湿性关节炎患者类风湿因子、C反应蛋白指标的变化与人类白细胞抗原-DRB1*0405的表达有关。

AIM: To investigate the relationship of human leucocyte antigen-DRB1 gene (HLA-DRB1) with the susceptibility of rheumatoid arthritis and whether the changes of erythrocyte sedimenttion rate, rheumatoid factor and C reactive protein in patients with rheumatoid arthritis have relation with human leucocyte antigen DRB1.METHODS: Forty one patients with rheumatoid arthritis (study group), who were treated or hospitalized in the First Affiliated Hospital of Dalian Medical University between February and June 2000, were randomly selected (dormantly allocated). Ninety two healthy physical examinees in the same area were taken as the controls (control group).Trace polymerase chain reaction sequence specific primer (PCR SSP) technique was used to study the distribution of human leucocyte antigen DRB1. Rheumatoid factor and C reactive protein were detected with immunoturbidimetric assay (ITA), and erythrocyte sedimenttion rate was detected with routine Westergren method.RESULTS: All the subjects in both groups were involved in the analysis of results according to the experimental demand.The occurrence frequency of DRB1* 0405, which was the allele of human leucocyte antigen DRB1 was obviously higher in the study group (59% ) than in the normal control group (26% ), and the relative risk was 4.00, and the occurrence frequencies of other alleles were almost the same in the two groups. The level of rheumatoid factor was markedly higher in human leucocyte antigen DRB1* 0405+ patients with rheumatoid arthritis [n=24, (73.4± 20.3)U/mL] than in human leucocyte antigen DRB1* 0405 patients with rheumatoid arthritis [n =17, (14.0± 7.2) U/mL] (t=10.25, P< 0.01).The C reactive protein level of human leucocyte antigen DRB1* 0405+ patients with rheumatoid arthritis [(29.1± 6.5) g/L] was remarkably higher than that of human leucocyte antigen DRB1* 0405 patients with rheumatoid arthritis [(3.2 ± 1.5) g/L](t=5.66,P< 0.01).CONCLUSION: The isoform of predisposing gene for patients with rheumatoid arthritis in Dalian area was human leucocyte antigen DRB1* 0405.The changes of rheumatoid factor and C reactive protein are correlated with the expression of human leucocyte antigen DRB1* 0405.