中国汉族慢性阻塞性肺疾病与人类白细胞抗原相关性研究

Association Research of Chinese Han Chronic Obstructive Pulmonary Disease and Human Leucocyte Antigen

目的：探索我国汉族人群人类白细胞抗原（ＨＬＡ）等位基因多态性与慢性阻塞性肺疾病（ＣＯＰＤ）的易感性。方法：对ＣＯＰＤ组及对照组进行ＨＬＡ分型和临床研究。结果：ＣＯＰＤ组ＨＬＡ－ＡＷ３０／３１，ＨＬＡ－ＢＷ５４位点抗原频率较对照组明显增高（频率４１％、３１％，相对危险率分别是９．０９和１０．９１，Ｐ＜０．０１）。ＡＷ３０／３１阳性者病程长，肺功能呈混合性通气障碍，多伴呼吸衰竭。伴副鼻窦炎者２３％（５／２２），ＴＢＬＢ呈肺泡上皮增生变厚，肺泡壁纤维组织弥漫增生。ＢＷ５４阳性者，病程相对短，肺功能呈重度阻塞性和轻度限制性通气障碍。伴副鼻窦炎者６０％（６／１０）。ＣＤ４／ＣＤ８升高，ＩｇＡ增加。ＴＢＬＢ呈淋巴细胞和浆细胞浸润、增生，少量纤维化。结论：ＣＯＰＤ与ＡＷ３０／３１，ＢＷ５４位点抗原密切相关——即具有ＡＷ３０／３１，ＢＷ５４抗原的人群易患ＣＯＰＤ。ＢＷ５４位点阳性者，可能是弥漫性泛细支气管炎。它们的确混淆在ＣＯＰＤ之中。

Objective:Association research of Chinese Han chronic obstructive pulmonary disease (COPD) and human leucocyte antigen(HLA).Methods:We performed the HLA A B C antigen analysis of patients of COPD and the clinical research.Results:The HLA A W30/31 and HLA B W54 significantly increased (frequency 41%,31%,RR 9.09,10.91 respectively P <0.01).HLA A W30/31 had long course,disorder of mixventilation in lung function.Company with respiretary failure,had paranasal sinusitis 23%(5/22).TBLB showed alveoli epitheliosis.alveoli wall fibroid tissue hyperplasia widely.HLA B W54 had sort course,disorder of obstrutive ventilation,had paranasal sinusitis 60% (6/10).CD 4/CD 8 increased,IgA increased also.TBLB showed lymphocyte erosion,hyperplasia a little fibrosis.Conclusion:On or some of the genes controlling the susceptibility and/or immune responsiveness of COPD might be located near HLA A W30/31 and B W54 ,the patients with HLA B W54 confused among COPD might be DPB.