CaSR986基因多态性与能谱CT泌尿系结石成分分析及临床特征的相关性

Correlation of CaSR986 gene polymorphism with clinical characteristics and urinary calculi composition by energy spectrum CT

目的:探讨钙敏感受体(Calcium sensing receptor,CaSR)986基因位点多态性与能谱CT泌尿系结石成分及临床特征的相关性。方法:选取2016年1月-2017年7月我院收治的98例泌尿系结石患者作为研究对象,作为实验组;收集同期于我院进行体检的50例健康者作为对照组。采用聚合酶链反应(PCR)联合DNA测序检测分析两组CaSR986位点基因型及等位基因构成差异,同时采用宝石能谱CT扫描,术前对实验组结石成分进行分析(以术后红外光谱分析法作为标准,排除结果差异者);随访1年,记录实验组结石复发情况及其成分。分析CaSR986各基因型分布与结石成分及临床特征之间的相关性,并采用Logistic回归法分析影响结石复发的独立危险因素。结果:实验组和对照组CaSR986基因分布符合Hardy-Weinberg定律,其基因型及等位基因构成比无显著差异(P>0.05);经能谱CT和红外光谱分析仪确认实验组含钙结石75例,非含钙结石23例;经Pearson相关性分析得知,含钙结石与Ca SR986 AA型呈现明显正相关(r=0.734,P<0.05);而含钙结石与CaSR986其它基因型、非含钙结石与CaSR986任何基因型均无明显相关性(P>0.05);CaSR986基因型分布在结石部位、结石复发及复发结石成分上差异具有统计学意义(P<0.05),但在结石直径及肾积水方面差异无统计学意义(P>0.05);经多因素校正后Logistic回归分析发现结石成分是影响泌尿结石复发的独立危险因素(P<0.05)。结论:宝石能谱CT可在术前分辨含钙结石,对泌尿结石复发预测具有一定价值,与CaSR986 AA基因型密切相关。

Objective:To explore the correlation of CaSR986 gene polymorphism with clinical characteristics and urinary calculi composition by the spectrum CT.Methods:Ninety-eight patients with urinary calculi admitted to our hospital from January 2016 to July 2017 were enrolled in the experimental group,and 50 healthy people in our hospital during the same period were collected as the control group.The genotype and allele composition of CaSR986 in the two groups were analyzed by polymerase chain reaction and DNA sequencing,and meanwhile the gemstone spectrum CT scan was used to analyze the composition in the experimental group before operation(using postoperative infrared spectroscopy as a standard,excluding the differences in the results).The recurrence and composition of stones in the experimental group were recorded with one year follow-up.The correlation between the distribution of each genotype of CaSR986,the stone composition and clinical features was analyzed.The independent risk factors of stone recurrence were analyzed by Logistic regression.Results:The distribution of CaSR986 gene in the experimental group and control group was in accordance with Hardy-Weinberg law,and there was no significant difference in genotype and allele composition between the two groups(P>0.05).Seventy-five cases of calcium stone and 23 cases of non-calcium stone were found in the experimental group by HDCT and FTIR automatic analysis.The pearson correlation analysis showed that calcium-containing stones were positively correlated with CaSR986 AA(r=0.734,P<0.05).However,there was no significant correlation between calcium-containing stones and other genotypes of CaSR986,non-calcium-containing stones and any genotype of CaSR986(P>0.05).CaSR986 genotype was significantly different in stone location,recurrence and recurrence components(P<0.05),but there was no significant difference in stone diameter or hydronephrosis(P>0.05).The Logistic regression analysis showed that stone composition was an independent risk factor for urinary calculi recurrence(P<0.05).Conclusion:Gemstone spectrum CT can distinguish calculus before operation which is valuable in predicting recurrence of urinary calculi and is closely related to CaSR986 AA genotype.