CTLA-4基因多态性与Graves病预后关系的研究

Research on the relationship between the A/G polymorphism of the T-lymphocyte- associated antigen-4 gene and the prognosis of Graves' disease

目的:对Graves病(GD)患者CTLA-4基因外显子1第17密码子49位点A/G多态性与GD患者的临床特点及其对抗甲状腺药物的疗效关系进行研究,为临床治疗的决策提供依据。方法:根据Graves病患者服用抗甲状腺药物的效果及其停药后是否复发分为A组(治疗效果较好、预后好组)与B组(难治性或易复发组)。应用PCR技术并采用限制性内切酶BbvI来测定其外周血单个核细胞CTLA-4基因外显子1第17密码子49位点A/G多态性。分析其基因表型、基因频率与临床表现及预后的关系。结果:难治性或易复发的GD患者GG基因型及等位基因G频率明显高于治疗效果较好、预后好的GD患者,而AG基因型及等位基因A频率则明显低于治疗效果较好、预后好的GD患者。结论:CTLA-4基因外显子1第17密码子49位点表现为GG基因型可能是Graves病患者对抗甲状腺药疗效差及甲亢易复发的重要原因。

Objective： To study the relationship between the exon 1A/G polymorphism of the CTLA-4 gene and the response to antithyroid drugs（ATD） in Graves＇ disease （GD）. Methods：GD patients were divided into two groups according to the response to antithyroid drug （ATD）： group A（prognosis is good） and group B（prognosis is bad or relapsed）. The exon 1A/G polymorphism of the CTLA-4 gene in monocytes in peripheric vein were detected with the technique of PCR and restriction endonucleases BbvI. Its genotype, allele frequencies as well as association of its genotype, allele frequencies to clinical character and the prognosis of Graves＇ disease were analysied. Results： There was distinct difference of GG genotype and G allele frequencies between group A and group B （P〈0.05）. Conclusion： The GG geneotype of the exon 1 of CTLA-4 gene may be a risk factor of the bad prognosis or relapsed .