白细胞分化抗原40配体G基因多态性与老年慢性乙型肝炎后肝硬化相关性及预后的关系

Relationship between leukocyte differentiation antigen 40 ligand G gene polymorphism and the correlation and prognosis of cirrhosis after chronic hepatitis B in the elderly

目的 探讨白细胞分化抗原40配体(CD40L)G基因多态性与老年慢性乙型肝炎后肝硬化相关性及预后关系。方法 选取2016年5月至2019年3月中国人民解放军联勤保障部队第九〇四医院(以下简称“我院”)收治的82例老年慢性乙型肝炎后肝硬化患者,记为研究组,并选择同期在我院进行体检的80名健康者为对照组。采集外周静脉血提取血液基因组DNA,测定CD40L基因多态性,并确定其基因型分布。结果 两组CD40L基因型均符合Hardy-Weinberg平衡定律。研究组G等位基因频率高于对照组(P <0.05)。logistic回归模型分析结果显示,CG、GG基因型的老年慢性乙型肝炎后肝硬化患者预后不良发生的相对危险度分别是CC基因型的1.809倍和2.264倍(P <0.05)。随访1年结束,CD40L G基因老年慢性乙型肝炎后肝硬化患者生存率为62.90%;CD40L非G基因老年慢性乙型肝炎后肝硬化患者生存率为85.00%;CD40L G基因与非G基因患者的生存曲线比较,差异有统计学意义(χ^(2)=6.138,P <0.05)。结论 老年慢性乙型肝炎后肝硬化患者G等位基因频率高于健康者;CD40L基因多态性与年慢性乙型肝炎后肝硬化患者预后死亡有关,该基因GG、CG基因型可增加死亡的发生风险。

Objective To investigate the relationship between the G gene polymorphism of leukocyte differentiation antigen 40 ligand(CD40L) and the prognosis of cirrhosis after chronic hepatitis B in the elderly. Methods A total of 82elderly patients with liver cirrhosis after chronic hepatitis B who were admitted to NO.904 Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army(“our hospital” for short) from May 2016 to March 2019were selected as the study group, and 80 healthy people who underwent physical examination in our hospital during the same period were selected as the control group. Peripheral venous blood was collected and blood genomic DNA was extracted, the CD40L gene polymorphism was determined, and its genotype distribution was determined. Results The CD40L genotypes of the two groups conformed to Hardy-Weinberg equilibrium law. The G allele frequency of the study group was higher than that of the control group(P < 0.05). The logistic regression model analysis showed that the relative risk of poor prognosis in elderly patients with CG and GG genotypes after chronic hepatitis B was 1.809 times and2.264 times that of the CC genotype(P < 0.05). At the end of the one year follow-up, the survival rate of elderly patients with CD40L G gene with liver cirrhosis after chronic hepatitis B was 62.90%. The survival rate of CD40L non-G gene cirrhosis after chronic hepatitis B was 85.00%. There was a statistically significant difference in the mortality curve of CD40L G gene and non-G gene patients(χ^(2)= 6.138,P < 0.05). Conclusion The frequency of the G allele in elderly patients with post-chronic hepatitis B liver cirrhosis is higher than that in healthy people. The CD40L gene polymorphism is related to the prognosis of death in patients with chronic hepatitis B after cirrhosis. The GG and CG genotypes can increase the risk of death.