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目的探讨HLA-G基因14bp插入/缺失多态性与类风湿关节炎(RA)易感性的相关性,并分析其不同基因型间RA患者临床特点的差异。方法多聚酶链式反应(PCR)检测154例RA患者及367名健康体检者的HLA-G基因14bp插入/缺失多态性,比较不同基因型RA患者间关节肿胀数、关节压痛数、关节晨僵时间、病情活动指数DAS28积分及实验室指标如C反应蛋白(CRP)、血沉(ESR)、类风湿因子(RF)、抗CCP抗体滴度的差异。结果HLA-G 14bp插入/缺失多态性基因型频率分布在正常人和RA患者均显示Hardy-Weinberg平衡(正常人组:χ2=0.095,p=0.953;RA组:χ2=0.533,p=0.766);HLA-G 14bp插入/缺失多态性基因和基因型频率与RA易感性均无显著性的相关性联系;与+14bp/+14bp和+14bp/-14bp基因型RA患者比较,-14bp/-14bp纯合子基因型RA患者的压痛关节数(p=0.049)、肿胀关节数(p=0.004)明显增多,病情活动指数DAS28明显更重(p=0.028),RF滴度更高(p=0.001)。结论HLA-G基因14bp插入/缺失多态性与RA疾病易感性无关,但可影响RA患者的临床表现,HLA-G—14/-14bp纯合子型可能作为预后不良因素参与到RA疾病机制之中。
Objective To investigate the association between the 14 bp insertion / deletion polymorphism of HLA-G gene and the susceptibility to rheumatoid arthritis (RA) and to analyze the clinical features of RA patients with different genotypes. Methods Polymerase chain reaction (PCR) was used to detect the 14 bp insertion / deletion polymorphism of HLA-G gene in 154 patients with RA and 367 healthy subjects. The incidence of joint swelling, joint tenderness, morning stiffness Time, index of disease activity index (DAS28), and laboratory parameters such as CRP, ESR, RF and anti-CCP antibody titers. Results The frequency distribution of HLA-G 14bp insertion / deletion polymorphism showed Hardy-Weinberg equilibrium in both normal and RA patients (normal group: χ2 = 0.095, p = 0.953; RA group: χ2 = 0.533, p = 0.766 ). There was no significant correlation between HLA-G 14bp insertion / deletion polymorphisms and genotype frequency and susceptibility to RA. Compared with + 14bp / + 14bp and + 14bp / -14bp genotype RA patients, -14bp (P = 0.049), the number of swollen joints (p = 0.004), the significantly heavier disease activity index (DAS28) (p = 0.028) and the higher RF titer in pts with / -14bp homozygous RA = 0.001). Conclusion The 14 bp insertion / deletion polymorphism of HLA-G gene is not associated with the susceptibility to RA but may affect the clinical manifestations of RA. The homozygous HLA-G-14 / -14bp may be involved in the pathogenesis of RA as a poor prognostic factor in.