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目的 探讨机体防御分子甘露糖结合蛋白 (mannose bindingprotein ,MBP)基因第 5 4号密码子多态性与IgA肾病(IgAnephropathy ,IgAN)患者肾小球免疫沉积类型的关系。方法 选取 147例IgAN患者 ,依据肾小球免疫沉积类型 ,分为两组 :A组 ,77例为单纯IgA伴C3沉积 ;AGM组 ,70例为IgA ,IgG ,IgM伴C3,C1q沉积。收集所有患者的临床和实验室相关资料。另选取 140名正常健康成人作正常对照。使用PCR RFLP法分析MBP基因第 5 4号密码子GGC/GAC多态性。结果 IgAN中AGM组患者MBP基因GGC/GAC基因型的发生频率明显高于A组 (41 4 %vs 19 5 %,P <0 0 1) ,而GGC/GGC基因型的发生频率明显低于A组患者 (5 5 7%vs76 6 %,P <0 0 1)。IgAN的AGM组患者GAC等位基因的发生频率明显高于A组患者 (0 2 36vs 0 136 ,P <0 0 5 ) ,而GGC等位基因的发生频率明显低于A组患者(0 76 4vs 0 86 4 ,P <0 0 5 ) ,变异型等位基因 (GAC)与IgAN的大量免疫沉积明显相关 (OR =1 95 ,95 %CI :1 0 6 -3 5 8)。无论在A组还是在AGM组 ,GAC等位基因携带者中起病时有前驱感染史者均显著多于GGC纯合子 (P <0 .0 5 )。结论 机体防御分子MBP的遗传变异与IgAN肾小球免疫沉积多样性有关 ,MBP基因变异型等位基因与IgAN患者大量免疫沉积?
Objective To investigate the relationship between immunodeficiency and glomerular immunodeficiency in patients with IgA nephropathy (IgA nephropathy) and the codon 54 of the human defensive molecule mannose binding protein (MBP) gene. Methods One hundred and seventy-one patients with IgAN were divided into two groups according to the type of glomerulonephritis: group A, 77 patients were simple IgA with C3 deposition, while AGM group, 70 patients were IgA, IgG, IgM with C3 and C1q deposition. Collect all patient’s clinical and laboratory related information. Another 140 normal healthy adults as normal control. PCR RFLP method was used to analyze the codon 54 codon GGC / GAC polymorphism of MBP gene. Results The frequency of GGC / GAC genotype of MBP gene in IgAN patients was significantly higher than that of A patients (41.4% vs 19.5%, P <0.01), while the frequency of GGC / GGC genotype was significantly lower than that of A Group patients (57 57% vs 76 6%, P <0.01). The frequency of GAC alleles in patients with IgAN in the AGM group was significantly higher than that in patients in the A group (0 2 36 vs 0 136, P 0 05), while the frequency of the GGC allele was significantly lower than that in the patients in the A group (0 76 4 vs 0 86 4, P <0 05). Variant alleles (GAC) were significantly associated with IgA immunoprecipitation (OR = 95 95% CI: 106-638). The incidence of prodromal infection in GAC allele carriers was significantly higher than that in GGC homozygotes (P <0.05) both in group A and group AGM. Conclusion The genetic variation of MBP is related to the diversity of IgAN glomerular immunoprecipitation.