HLA-DR基因与乙型肝炎病毒慢性感染结局的相关性  

Associations between HLA-DR genes and clinical outcomes in patients with chronic hepatitis B virus infection

作　　者：柳富会[1] 李建忠[1] 李长缨 王义成[1] 

机构地区：[1]青岛大学医学院教学医院,青岛市传染病医院,山东青岛266033 [2]青岛市中心血站,山东青岛266000

出　　处：《中国医疗前沿（学术版）》2008年第9期25-26,共2页China Healthcare Innovation

摘　　要：目的探讨HLA-DR基因与乙型肝炎病毒慢性感染临床结局的相关性。方法选择乙型肝炎病毒慢性感染者,包括慢性乙型肝炎患者102例,HBV相关性肝硬化38例,HBV相关性肝癌患者34例,健康对照组为健康骨髓捐献者1383例,HLA-DR基因型用PCR-SSP法进行检测。结果HLA-DR1基因型频率在健康对照组和CHB组间无显著差异(Pc>0.05),LC、HCC组中HLA-DR1基因型频率明显高于CHB组(x2=5.667,P=0.017)及健康对照组(xc2=9.438,Pc=0.002);HLA-DR13基因在健康对照组与LC、HCC组间无显著差异(Pc>0.05),但CHB组中HLA-DR13基因型的频率明显低于与健康对照组(x2=2.764,P=0.096)和LC、HCC组(xc2=6.479,Pc=0.012)。在CHB、LC和HCC三组间HLA-DR12和HLA-DR15基因频率无显著差异(P>0.05),但HBV慢性感染者中HLA-DR12基因型频率高于健康对照组(x2=16.320,P=0.000),而HLA-DR15基因型频率则低于健康对照组(x2=8.452,P=0.004)。结论HLA-DR12和HLA-DR15基因可能分别是HBV感染慢性化的易感和拮抗因素,HLA-DR1基因可能与HBV慢性感染后肝硬化、肝癌等不良结局发生有关,HLA-DR13虽可能保护宿主不易形成HBV慢性感染,但HLA-DR13阳性的HBV慢性感染者却易于发生肝硬化或肝癌等不良结局。Objective To investigate the associations between HLA-DR genes and the clinical outcomes in patients with chronic hepatitis B virus infection.Methods HLA-DR genes in the patients with chronic hepatitis B virus infection, including 102 patients with chronic hepatitis B, 38 liver cirrhosis and 34 hepatocellular carcinoma, and 1383 health marrow donors enrolled to be control group, were detected by polymerase chain reaction-sequence specific primer （PCR-SSP） technique Results The frequency of HLA-DR1 gene was not significantly different between the control group and CHB group （P c〉0.05）, the frequency of HLA-DR1 gene was significantly higher in the LC and HCC group than that in the CHB group （x^2 =5.667, P=0.017） and that in the controll group （xc^2=9.438, Pc=0.002）. The frequency of HLA-DR13 gene was not significantly different between the control group and the LC and HCC group （P c〉0.05）, but the frequency in the CHB group was significantly lower than that in the control group （x^2 =2.764, P=0.096） and that in the LC and HCC group（xc^2=6.479, Pc=0.012）. There were no difference in both of the frequency of HLA-DR12 and -DR15 gene among the CHB, LC and HCC group （P〉0.05）. The frequency of HLA-DR12 gene was significantly higher in patients with chronic HBV infection than that in control group （x^2 =16.320,P=0.000）, and the frequencies of HLA-DR15 gene were significantly lower in patients with chronic HBV infection than that in control group （x^2 =8.452,P=0.004）. Conclusion HLA-DR12 and -DR15 gene may be the susceptible factor and the resistant factor associated with the persistence of HBV infection, respectively. HLA-DR1 gene may closely associated with the susceptivity to LC or HCC in patients with chronic HBV infection. HLA-DR13 gene can protect the hosts from chronic HBV infection, but HLA-DR13 gene positive patients with chronic HBV infection may be susceptible to infaust clinical outcomes, such as LC or HCC.

关 键 词：人类白细胞抗原DR基因 乙型肝炎病毒 临床结局 

分 类 号：R512.62[医药卫生—内科学]