血管紧张素转换酶缺失等位基因与IgA肾病预后的关系

Association of ACE gene insertion/deletion polymorphism with IgA nephropathy

目的探讨ACE基因插入/缺失多态性与IgA肾病发生发展的关联。方法利用一对侧翼引物及一对序列特异性引物和多聚酶链反应(PCR)技术,对ACE基因多态性及其与IgA肾病的关联进行相关分析。结果肾活检时血清肌酐升高的IgA肾病患者DD基因型频率明显增高(P<0.05);而Ⅱ基因型频率在轻度肾小球病变组明显增高(P<0.05)。结论ACE-DD基因型与肾活检时肾功能减退有关,而Ⅱ基因型与轻度肾小球病变有关。提示ACE-D等位基因可能是IgA肾病预后不良的遗传标志。

Objective To investigate the relationship between ACE gene insertion/deletion（I/D） polymorphism and the clinicopathological manifestations in patients with IgA nephropathy（IgAN）. Methods A flanking primer pair and an insertion-specific primer pair were used to perform two polymerase chain reactions, so as to analyze the I/D polymorphism of ACE gene. Results There was no significant difference of ACE genotype frequency between IgAN patients and controls. The frequency of DD genotype was higher in patients with renal insufficiency, while Ⅱ genotype frequency was markedly higher in patients with mild rlomerular lesion （ P 〈 0.05）. Conclusion We observed a significant association of the deletion polymorphism of ACE gene with renal insufficiency at biopsy. The D allele may play a role in the deterioration in IgAN, and the I allele may act as a protecting factor in the progress.