病理为非IgA系膜增生性肾小球肾炎的小儿肾病综合征HLA-DRBl基因分型

HLA-DRB1 genotyping in children with nephrotic syndrome of non-IgA mesangial proliferative glomerulonephritis

目的研究山西汉族小儿以原发性肾病综合征为临床表现的非IgA系膜增生性肾小球肾炎（MsPGN）与HLA-DRBl基因的相关性。方法应用聚合酶链反应一序列特异性引物技术（PCR-SSP）检测20例病理为非IgA MsPGN的小儿肾病综合征HLA-DRBl基因特异性，从而确定该病的HLA分型。结果20例以原发性肾病综合征为临床表现的非IgAMsPGN患儿的HLA-DRBl等位基因频率与对照组比较，HLA-DRBl＊11明显增高，差异有统计学意义（22．50％ vs 8．33％，X^2=9．544，P=0．002，CI=1．674～9．995，RR=4．09）。9例HLA-DRBl＊11阳性患儿全部伴血尿、血压增高和短暂的肾功能受累。结论山西汉族以原发性。肾病综合征为临床表现的非IgA MsPGN患儿与HLA-DRBl＊11有显著相关性，具有此基因者易伴血尿、高血压及短暂的肾功能受累。为揭示该病发病机制中免疫遗传学机制所起的作用提供了重要线索和依据。

Objective To investigate the association of HLA-DRB1 alleles in Han population of Shanxi children with nephrotic syndrome of non-IgA mesangial proliferative glomerulonephritis （MsPGN）. Methods HLA-DRB1 was performed by polymerase chain reaction-sequence specific primers technique, and twenty patients with nephrotic syndrome of non-IgA MsPGN were detected. Results Analysis of the frequencies of specific at the HLA-DRB1 loci revealed significantly higher frequencies of HLA-DRB1＊11 alleles among the nephrotic syndrome patients of non-IgA MsPGN comparing with controls （22. 50% vs 8.33% , X2 = 9. 544, P =0. 002, CI = 1. 674-9. 995, RR= 4.09）. Nine patients with HLA-DRB1＊11 all accompanied hematuria, hypertension or short renal insufficiency. Conclusion The results suggested that HLA-DRB1＊11 alleles contribute to genetic susceptibility to nephritic syndrome of non-IgA MsPGN. The patients with HLA-DRB1＊11 easy accompanied hematuria, hypertension or short renal insufficiency.