HBeAg阳性慢性乙肝患者红细胞补体受体Ⅰ型分子基因点突变的分布及意义

Distribution and significance of spots mutation of complement receptor type 1 gene of erythrocytes in patients with E antigen positive

目的:研究免疫耐受与应答组HBeAg阳性慢性乙肝患者红细胞补体受体Ⅰ型分子(complement receptor type1,CR1)基因点突变分布特点及数量水平,并分析其临床意义。方法:选择114例肝脏功能正常、血清HBV DNA含量大于106IU/mL的HBeAg阳性慢性乙肝患者作为免疫耐受组研究对象,选择110例初次转氨酶高于正常值2倍以上伴或不伴有肝细胞性黄疸的HBeAg阳性慢性乙肝患者为免疫应答组研究对象。采用PCR和HindⅢ酶切技术对红细胞CR1分子基因点突变进行分类,并采用酶联法定量测定红细胞CR1分子数量水平。结果:免疫耐受组红细胞CR1基因无点突变的患者明显低于应答组(P<0.05);免疫耐受与应答组的女性患者其无点突变百分率明显高于男性患者(P<0.05);在红细胞CR1基因无点突变的患者中,耐受组患者CR1分子数量较应答组明显下降(P<0.05);发生点突变个体的CR1分子数量明显低于未发生点突变的患者(P<0.01)。结论:红细胞CR1基因点突变与HBeAg阳性慢性乙肝患者的免疫反应状态有关,女性患者以无点突变类型为多。

Objective To study the distribution and significance of spots mutation of complement receptor type 1 （CR1） of erythrocytes in patients with E antigen positive of immune response and suppression. Methods 114 patients of E antigen positive with normal hepatic function and the concentration of HBV DNA much more 106 IU/mL in sera have been studied in groups of immune suppression. 110 cases with initial hepatogenic jaundice and twice over normal level in ALT has been used as groups of immune response. Genomic density polymorphism of complement receptor type 1 （CR1） of erythrocytes has been classified by Polymerase chain reaction （PCR） and Hind m restriction enzyme digestion. And quantitative assay of CR1 was used. Results The ratio of CR1 gene spots mutation in immune suppressive groups are obviously higher than that of immune responsive groups （P 〈 0.05）. The ratio of CR1 gene with non-spots mutation in female in two groups are significantly higher than that of male （P 〈 0.05）. The amounts of CRI in patients with CR1 gene spots mutation are obviously less than that in patients without spots mutation. Conclusions The CR1 gene spots mutation is related to immunity state of patients with E antigen positive. The type of CR1 gene with none of spots mutation is primary in female patients infected HBV with E antigen positive.