IgA肾病肾功能损害患者肾素-血管紧张素系统基因多态性研究

Gene Polymorphism of Renin Angiotensin System in IgA Nephropathy Patients with Renal Damage

目的探讨IgA肾病肾功能损害患者肾素-血管紧张素系统(RAS)的3个主要基因,即血管紧张素Ⅱ1型受体(AT1R)基因A1166C、血管紧张素Ⅰ转化酶(ACE)基因插入/缺失(I/D)和血管紧张素原(AGT)基因M235T的多态性。方法选取2010年6月—2012年7月右江民族医学院附属医院和百色市人民医院确诊的IgA肾病患者68例为肾病组,根据肾小球滤过率分为肾功能损害组4例和无肾功能损害组64例;选取2012年7月在右江民族医学院附属医院体检的与肾病组患者性别构成、年龄匹配的健康人70例为对照组。采用直接聚合酶链反应和聚合酶链反应-限制性片段长度多态性技术检测ACE基因I/D、AT1R基因A1166C和AGT基因M235T的基因型。结果肾病组与对照组ACE基因I/D基因型分布比较,差异有统计学意义(P<0.05);两组AT1R基因A1166C、AGT基因M235T基因型分布比较,差异无统计学意义(P>0.05)。肾功能损害组与无肾功能损害组ACE基因I/D基因型分布比较,差异有统计学意义(P<0.05);两组AT1R基因A1166C和AGT基因M235T基因型分布比较,差异无统计学意义(P>0.05)。结论 ACE基因I/D多态性与IgA肾病的发生、出现肾功能损害有关,DD基因和D等位基因是IgA肾病患者发生肾功能损害的易感因素。

Objective To explore the polymorphism of the 3 main genes of rennin angiotensin system,namely angiotensin Ⅱ type 1 receptor（AT1R） geneA1166C,angiotensin Ⅰconverting enzyme（ACE） gene insertion / deletion（I / D） and angiotensinogen（AGT） gene M235T,in IgA nephrophathy patients with renal damage.Methods Sixty-eight IgA nephropathy patients（IgA N group） were subdivided,according to glomerular filtration rate,into groups impaired kidney function（IKF,n =4）,non-IKF（n =64）.Seventy healthy subjects were enrolled as control group.Direct polymerase chain reaction and polymerase chain reaction-restriction fragment length polymorphism were used to determine the genotypes of ACE geneI / D,AT1R gene A1166C,AGT gene M235T.Results There was significant difference in distribution frequency of ACE gene I / D genotype between groups IgA N and control（P〈 0.05）,but there was no in distribution frequency of AT1R gene A1166C,AGT gene M235T genotype（P〈 0.05）.There was difference in distribution frequency of ACE gene I / D genotype between groups IKF and non-IKF（P〈 0.05）,but there was no in distribution frequency of AT1R gene A1166C,AGT gene M235T genotype（P〈 0.05）.Conclusion ACE I / D polymorphism is related to IgA nephropathy development and kidney function damages.DD gene and D allele are predisposing factors of kidney function damages in IgA nephropathy patients.