结核病与主要组织相容性复合体Ⅱ类基因的关联性研究

A study on association of tuberculosis with major histocompatibility complex genes

目的研究中国北方汉族儿童结核病与主要组织相容性复合物（ＭＨＣ）Ⅱ类基因的关联，以探讨结核发病的免疫遗传机制。方法采用聚合酶链式反应序列特异性寡核苷酸探针斑点杂交（ＰＣＲＳＳＯＰ）方法，测定原发性肺结核２０例、结核性胸膜炎２８例、粟粒型肺结核１９例、结核性脑膜炎３６例和９１例正常对照组的ＭＨＣＤＲＢ１，ＤＱＡ１，ＤＱＢ１等位基因。结果在４种结核患儿中ＤＲＢ１１５０１显著增高，在粟粒型肺结核、结核性脑膜炎、原发性肺结核和结核性胸膜炎中相对风险（ＲＲ）分别为７２２，７５８，１３３３和３８４，校正Ｐ（Ｐｃ）均＜００５；ＤＲＢ１１２０２在粟粒型肺结核、结核性脑膜炎和原发性肺结核组增高，ＲＲ分别为２７７、３４６和１８３，而在结核性胸膜炎组降低，ＲＲ为０１７，Ｐｃ均＞００５。ＤＲＢ１１２０１在原发性肺结核、结核性胸膜炎增高，ＲＲ分别为２４２、２６１，在粟粒型肺结核和结核性脑膜炎降低，ＲＲ分别为０４９和０６２，Ｐｃ均＞００５。ＤＲＢ１１５０２、１６０２、０９０１在各型结核患儿中表现为减少，但Ｐｃ均＞００５。结论中国北方汉族儿童结核病与ＭＨＣＤＲ基因有显著关联，其关联集中在ＤＲ?

Objective To explore the immungenetic basis of and the association of MHC class genes with tuberculosis in Han children in northern regions of China Methods MHCDRB1, DQA1, DQB1 were examined by using polymerase chain reaction/sequence specific oligonuleotide probe (PCR/SSOP) methods in 19 patients with miliary tuberculosis (MT), 36 with tuberculous menigitis (TM),20 with primary tuberculosis (PT), 28 with tuberculous pleurisy (TP) and 91 controls Results The gene frequencies of DRB1*1501 were markedly increased in the children with 4 types of tuberculosis The values of relative risk (RR) were 722, 758, 1333 and 384 in MT, TM, PT and TP, respectively (the corrected P value, i.e., Pc<005) DRB1*1202 increased in MT, TM and PT(RR=277, 346 and 183, respectively) and decreased in TP (RR=017, Pc>005) DRB1*1201 increased in PT and TP (RR=242 and 261) and decreased in MT and TM (RR=049 and 062, Pc>005) DRB1*1502, 1602, 0901 decreased in the 4 groups (Pc>005) Conclusion Tuberculosis of children in north China is significantly associated with MHCDRB1*1501 The subtypes of genes with decreased frequencies in the 4 groups were not completely the same, which might mean certain protective function