系膜增生性IgA肾病患者HLA-DRB1基因分型的研究

Study on HLA-DRB1 shared epitope in patients with IgA mesangial proliferative glomerulonephritis

目的:探讨HLA-DRB1基因多态性与系膜增生性IgA肾病(Ms PGN)的临床相关性。方法:164例IgA Ms PGN患者和164例健康受试者常规检查肾功能,采用PCR法测定HLA-DRB1基因分型,比较IgA Ms PGN患者和健康受试者的肾功能及HLA-DRB1基因分型,并且分析IgA Ms PGN患者HLA-DRB1基因分型与肾功能的关系。结果:(1)IgA Ms PGN患者和健康受试者24 h尿蛋白、血清肌酐和血清尿素氮差异具有统计学意义(P<0.01);(2)在IgA Ms PGN患者中,HLA-DRB1高频等位基因为DRB1*04、DRB1*07、DRB1*09、DRB1*11、DRB1*14和DRB1*15;(3)与健康受试者相比,DRB1*09和DRB1*11在IgA Ms PGN患者的分布频率显著升高(P<0.01或P<0.05);(4)DRB1*09和DRB1*11类型患者24 h蛋白尿、血清肌酐及血清尿素氮较HLA-DRB1其他基因类型的患者显著升高(P<0.01)。结论:HLA-DRB1基因多态性与系膜增生性IgA肾病相关,DRB1*09和DRB1*11类型可增加系膜增生性IgA肾病的风险,并且与患者肾小球肾炎严重程度有关。

Objective： To explore the clinical correlation of HLA-DRB1 shared epitope with IgA mesangial proliferative glomerulonephritis（ IgA MsPGN）. Methods： The renal function were examined routinely,and HLA-DRB1 shared epitope were determined by PCR in a total of 164 patients with IgA MsPGN and 164 healthy subjects. The renal function and HLA-DRB1 shared epitope were compared in patients with IgA MsPGN and healthy subjects,and clinical correlation of HLA-DRB1 shared epitope and renal function were analyzed. Results：（ 1） 24 h proteinuria,serum creatinine and serum urea nitrogen were significantly different in patients with IgA MsPGN and healthy subjects（ P〈0. 01）;（ 2） The high-frequency gene of HLA-DRB1 in patients with IgA MsPGN were DRB1 ＊ 04,DRB1＊ 07,DRB1＊ 09,DRB1＊ 11,DRB1＊ 14 and DRB1＊ 15;（ 3） The distribution frequency of DRB1 ＊ 09 and DRB1 ＊ 11 in patients with IgA MsPGN increased significantly（ P〈0. 01 or P〈0. 05）;（ 4） 24 h proteinuria,serum creatinine and serum urea nitrogen in patients with IgA MsPGN with DRB1＊ 09 and DRB1＊ 11 were significantly different compared with those in patients with IgA MsPGN with other HLA-DRB1 shared epitope（ P〈0. 01）. Conclusion： HLA-DRB1 shared epitope is related to IgA MsPGN,DRB1 ＊ 09 and DRB1＊ 11 can increase the risk of IgA MsPGN,and related to the severity of glomerulonephritis.