慢性丙型肝炎患者中医证型与白细胞介素-28B基因多态性的关系

Relationship between Syndrome Types of Traditional Chinese Medicine and IL28B Gene Polymorphisms in patients with chronic hepatitis C

目的:研究CHC患者中医证型与白细胞介素28B(IL-28B)单核苷酸多态性(SNP)的关系,探讨中医证候的分子学机理。方法:通过回顾性研究,收集245例住院CHC患者的一般临床资料、中医证型和肝功能指标(ALT、AST、GGT、DBil、TBil、ALP和Alb)、HCV RNA含量,采用DNA测序技术检测CHC患者IL28B SNPs(rs12980275、rsl2979860、rs8099917和rs10853728)基因型,并与235例健康对照组比较。用SPSS 20.0软件分析各数据与中医证型的相关性。结果:245例CHC患者中医证型分布规律为肝郁脾虚证最多(177例,72.2%),其余证型分别为瘀血阻络证(38例,15.5%)、肝肾阴虚证(22例,9.0%)、肝胆湿热证(7例,2.9%)和脾肾阳虚证(1例,0.4%);肝郁脾虚证患者在年龄、AST、DBil、TBil、ALP和HCV RNA含量与其他证型比较,差异有显著性意义(P<0.01),且多见于年轻的、肝功能损伤程度较轻和HCV RNA含量较低的患者;肝郁脾虚证CHC患者的rs12980275 AA基因型和rs8099917 TT基因型和rsl2979860 CC基因型均显著高于其他证型(P<0.05,P<0.01),IL-28B 5NP与健康对照组比较,差异无显著性意义(P>0.05)。结论:CHC患者中医证型以肝郁脾虚证最多;年龄和肝功能某些指标在不同中医证型之间存在差异,CHC患者中医证型与IL-28B基因某些位点的多态性相关,值得深入研究。

Objective：To investigate the relationship between syndrome types of traditional Chinese medicine（TCM） and IL28 B gene polymorphisms in patients with chronic hepatitis C.Methods：A total of 245 patients were enrolled retrospectively.The general characteristics,TCM syndromes,data of liver function（ALT,AST,GGT,DBIL,TBIL,ALP,and ALB） and HCV RNA were collected.IL28 B single nuclear polymorphisms（SNPs）（rsl2980275,rsl2979860,rs8099917,and rsl0853728） of all patients and 235 health control were detected by DNA sequencing.The correlations between TCM syndromes and data were analyzed using the SPSS 20.0.Results：Among 245 patients in the study,the pattern of liver-depression and spleen-deficiency was maximum（177 cases,72.2%）,the rest of patients were obstruction of collaterals by blood stasis type（38 cases,15.5%）,yin deficiency of liver and kidney type（22 cases,9.0%）,damp-heat blocking in liver and gallbladder（7 cases,2.9%） and yang deficiency of spleen and kidney（1 case,0.4%） respectively.For age,AST,DBIL,TBIL,ALP and HCV RNA,the difference were significant between liver-depression and spleen-deficiency type and other TCM syndromes（P 0.01）.The majority patients of liver-depression and spleen-deficiency type were younger,milder liver damage,and lower load of HCV RNA.There was no statistical difference in the 1L28 B SNP between the patients of liver-depression and spleen-deficiency type and health group（P〈0. 05）.Rs12980275 genotype AA and rs8099917 TT in the patients of liver-depression and spleen-deficiency type were significantly higher than that in other TCM syndromes（P0.01）,while for rs12979860 genotype CC,there was no statistical difference in two groups（P〈0. 05）.Conclusion：There were some relationship between TCM symptoms and objective indexes such as age,biochemical markers of liver and IL28 B SNP in patients with CHC,which were worth further study.