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目的探讨PAI-1基因启动子区4G/5G多态性与IgA肾病的发生、进展和临床表现的关系。方法收集IgA肾病患者的临床资料;应用PCR-限制性片段长度多态技术分析296例IgA肾病患者和310名健康人的PAI-1基因4G/5G多态性;分析PAI-1基因4G/5G多态性与IgA肾病的发生与临床表现及病理改变的关系。结果(1)PAI-1基因4G4G,4G5G,5G5G基因型频率在IgA肾病组和正常对照组分别为0·33、0.19、0.48和0.3、0.23、0.47,两组之间差异无统计学意义(χ2=1.63,P>0.05);(2)4G4G纯合子基因型频率在病理Lee氏分级Ⅲ级以下组(A组)和Ⅳ~Ⅴ级组(B组)分别为0.39和0.28,(χ2=7.86,P<0·05)。(3)按基因型分组,4G4G组IgA肾病患者的肌酐清除率明显低于非4G4G组;4G4G组患者的血清甘油三酯水平明显高于5G5G组;4G4G组患者高甘油三酯血症发生率明显高于4G5G组(P<0.05)。结论PAI-1基因启动子区4G/5G多态性不是IgA肾病发生的易感因素,但可能是IgA肾病病情加重的危险因子。
Objective To investigate the relationship between the 4G / 5G polymorphism of PAI-1 gene promoter and the occurrence, progression and clinical manifestations of IgA nephropathy. Methods The clinical data of patients with IgA nephropathy were collected. The 4G / 5G polymorphism of PAI-1 gene in 296 IgA nephropathy patients and 310 healthy individuals was analyzed by PCR-restriction fragment length polymorphism. The PAI-1 gene 4G / 5G Relationship between Polymorphism, IgA Nephropathy and Clinical Features and Pathological Changes. Results (1) The frequencies of 4G4G, 4G5G and 5G5G genotypes of PAI-1 gene were 0.33,0.19,0.48 and 0.3,0.23 and 0.47 in IgA nephropathy group and normal control group, respectively. There was no significant difference between the two groups (χ2 = 1.63, P> 0.05). (2) The frequency of 4G4G homozygote genotypes was 0.39 and 0.28 in group Lee (grade A) and grade IV to V (grade B) 7.86, P <0.05). (3) According to the genotypes, the creatinine clearance rate of patients with IgA nephropathy in 4G4G group was significantly lower than that of non-4G4G group; the serum triglyceride level in 4G4G group was significantly higher than that of 5G5G group; the incidence of hypertriglyceridemia in 4G4G group Significantly higher than 4G5G group (P <0.05). Conclusion The 4G / 5G polymorphism of PAI-1 gene promoter region is not a predisposing factor for IgA nephropathy, but may be a risk factor for aggravated IgA nephropathy.