Fas配体启动子区-844T／C单核苷酸多态性与重型乙型肝炎转归的关系

Relationship between-844T/C polymorphisms of Fas ligand gene promoter and fulminant hepatitis B

目的探讨中国汉族人Fas配体（FasL）基因单核苷酸多态性与重型乙型肝炎之间的关系。方法采用病例一对照研究方法，将HBV感染者作为研究对象。收集相关的非活动性HBsAg携带者233例，重型肝炎患者68例，HBV自发清除者100例，肝硬化患者102例，肝细胞癌患者112例的全血标本及临床相关资料。应用TaqMan探针实时荧光分型PCR方法检测患者Fasl基因-844T／C位点的基因多态性，计算比值比（OR）值及95％可信区间（C1）。结果应用二元Logistic回归分析，控制年龄、性别等因素后，非活动性HBsAg携带者的FasL-844CC、CT、TT基因型频率分别为50．64％、39．91％及9．44％；重型肝炎组中FasL-844CC、CT、TT基因型频率分别为79．41％、17．65％及2．94％。携带FasL-844CC基因型的非活动性HBsAg携带者与重型肝炎的发生呈显著关联（OR=4．729，95％CI：0．510～21．282，P=0．043），而其他病例对照组中存在的关联差异均无统计学意义（P〉0．05）。结论携带FasI。844CC基因型的非活动性HBsAg携带者易发生乙型肝炎重症化，应对这部分人群给予更多的关注。

Objective To investigate the relationship between single nucleotide polymorphism （SNP） of Fas ligand （FasL） and fulminant hepatitis B in Han Chinese. Methods HBV infected subjects were enrolled in this case-control study, including 233 cases of inactive HBsAg carrier, 68 patients with fulminant hepatitis B, 100 cases of spontaneous hepatitis B clearance, 102 patients with hepatitis B virus （HBV） related cirrhosis and 112 patients with HBV related primary hepatocellular carcinoma. The blood samples and clinical data were collected. FasL-844T/C polymorphisms of enrolled subjects were examined by TaqMan real time fluorescent genotyping polymerase chain reaction （RT-PCR）. A adjusted odds ratios （OR） and 95 G confidence intervals （CI）were calculated using the Logistic regression model. Results After adjusting the factors of gender and age, binary Logistic regression analyses indicated that the genotype frequencies of FasL-844 CC,CT,TT in inactive HBsAg carriers were 50.64% ,39. 91% and 9. 44%, respectively, and those in cases of fulminant hepatitis B were 79. 41%, 17. 65% and 2. 94%, respectively. The analysis also revealed that FasL-844CC genotype in inactive HBsAg carriers was high risk factor of developing fulminant hepatitis B （OR = 4. 729,95%CI：0. 510-21. 282,P=0. 043）, while there were no statistic significances in other cases （P〉 0. 05）. Conclusion The inactive HBsAg carriers harboring FasL-844CC may have greater susceptibility to fulminant hepatitis B, which need arouse high attention.