创伤后多器官功能不全综合征与HLA-DRB1基因的相关性研究

Study on correlation between post traumatic MODS and HLA-DRB1 alleles

目的 研究HLA -DRB1基因与创伤后多器官功能不全综合征 (MODS)的相关性。 方法 采用多聚酶链反应 -序列特异性引物分析法 (PCR -SSP) ,对 37例创伤后MODS患者HLA -DRB1基因进行分型 ,用酶联免疫吸附试验 (ELISA)进行血浆白细胞介素 - 10 (IL - 10 )测定 ,并与相应健康人 5 2例结果比较。 结果 创伤后MODS患者HLA -DRB1 15 0 1～DRB1 15 0 2 (编码HLA-DR2抗原 )基因频率显著升高 [5 1.4%∶2 6 .9% ,χ2 =4.5 32 ,相对危险率 (RR) =2 .86 5 ,P <0 .0 5 ,病因分数 (EF) =0 .49]。DR2 +的MODS患者血浆IL - 10水平较DR2 -的MODS患者显著升高 (P <0 .0 1) ,DR2 +的MODS患者病死率亦较DR2 -的MODS患者显著升高 (P <0 .0 5 )。 结论 创伤后MODS易感性与宿主HLA -DRB1 15 0 1～DRB1 15 0 2密切相关。

Objective To investigate correlation between post traumatic multiple organ dysfunction syndrome(MODS) and human leukocyte antigen-DRB1 alleles (HLA-DRB1 alleles). Methods All 18 pairs of primers of HLA-DRB1 alleles were analyzed by polymorphism chain reaction-sequence specific primer (PCR-SSP) in 37 patients with post traumatic MODS and in 52 normal subjects. Enzyme linked immunosorption assay (ELISA) was also used to measure plasma interleukin-10 (IL-10) level in 2 groups. Results The genetic frequency of HLA-DRB1*1501-DRB1*1502 which encoding HLA-DR2 was remarkably increased in patients with post traumatic MODS (51.4%∶26.9%,χ 2=4.532,RR=2.865, P <0.05,EF=0.49).Plasma IL-10 level was significantly high ( P <0.01). Mortality was noticeably higher ( P <0.05) in DR2 + MODS than that in DR2 - MODS. Conclusions The susceptibility of MODS in traumatic patients is closely related with HLA-DRB1*1501-DRB1*1502.