系统性红斑狼疮ABCG1和GALNT2基因启动子区甲基化的临床意义  

Clinical Significance of ABCG1 and GALNT2 Gene Promoter Methylation in Systemic Lupus Erythematosus

作　　者：曹程 王庆凯[1] 杨宝刚[1] 马明静[1] CAO Cheng;WANG Qingkai;YANG Baogang;MA Mingjing(Department of Cardiology,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou 061001,Hebei,China)

机构地区：[1]河北省沧州中西医结合医院心内科,河北沧州061001

出　　处：《心血管病学进展》2021年第12期1148-1153,共6页Advances in Cardiovascular Diseases

基　　金：沧州市重点研发计划指导项目(172302031)。

摘　　要：目的探讨ABCG1和GALNT2基因启动子区甲基化在系统性红斑狼疮(SLE)中的临床意义。方法选取2014年1月—2017年1月河北省沧州中西医结合医院收治的SLE患者123例,以是否发生肺动脉高压(PH)分为合并PH组(SLE-PH组)与不合并PH组(SLE-noPH组),比较两组患者临床资料和ABCG1、GALNT2基因启动子区甲基化情况,采用Kaplan-Meier生存分析ABCG1、GALNT2基因启动子区甲基化SLE患者3年生存率变化,采用向前法Cox模型多因素分析SLE、SLE-PH患者不良预后危险因素。结果SLE-PH组雷诺现象、活动后胸闷、指端血管炎构成比和右心室内径、右心房上下径、右心房左右径、肺动脉宽度、SLE疾病活动度指数(SLEDAI)、ABCG1甲基化比率、GALNT2甲基化比率均显著高于SLE-noPH组(P<0.05),而左心室内径和美国纽约心脏病协会(NYHA)分级(Ⅰ~Ⅱ)构成比显著低于SLE-noPH组(P<0.05)。ABCG1甲基化组平均生存时间显著低于ABCG1非甲基化组(Log-Rankχ^(2)=4.076,P=0.043)。SLE患者中,死亡组雷诺现象、肺间质病变、ABCG1甲基化比率和右心室内径、右心房上下径、右心房左右径、肺动脉宽度、SLEDAI均显著高于存活组(P<0.05),而NYHA分级(Ⅰ~Ⅱ)构成比率显著低于存活组(P<0.05);在SLE-PH患者中,死亡组雷诺现象构成比率和SLEDAI均显著高于存活组(P<0.05),而NYHA分级(Ⅰ~Ⅱ)构成比率显著低于存活组(P<0.05)。NYHA分级(Ⅲ~Ⅳ)、SLEDAI(≥20分)、ABCG1甲基化是SLE患者不良预后的危险因素(P<0.05),NYHA分级(Ⅲ~Ⅳ)是SLE-PH患者不良预后的危险因素(P<0.05)。结论ABCG1、GALNT2甲基化在SLE-PH呈高水平,ABCG1甲基化会增加SLE患者不良预后风险,GALNT2、ABCG1甲基化对SLE-PH不良预后影响不明显。Objective To explore the clinical significance of ABCG1 and GALNT2 gene promoter methylation in systemic lupus erythematosus(SLE).Methods A total of 123 patients with SLE admitted in Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2014 to January 2017 were enrolled,and divided into PH combination(SLE-PH)and non-PH combination(SLE-noPH)group.Clinical data,ABCG1 and GALNT2 gene promoter methylation were compared between both groups.Changes in 3-year survival rate of SLE patients with ABCG1 and GALNT2 gene promoter methylation were assessed by Kaplan-Meier survival analysis.Risk factors for poor prognosis were calculated by forward multivariate Cox regression analysis.Results The proportions of Raynaud’s phenomenon(PRP),chest tightness after activity and fingertip vasculitis,right ventricular diameter(RVD),suprainferior diameter of right atrium(SDRA),left and right diameter of right atrium(LRRA),pulmonary artery width,SLE disease activity index(SLEDAI),proportions of ABCG1 and GALNT2 methylation in SLE-PH group were significantly higher than SLE-noPH group(P<0.05),with a lower left ventricular diameter and proportion of New York Heart Association(NYHA)classⅠtoⅡ(P<0.05).The average survival time was shorter in ABCG1 methylation group than non-methylation(Log-Rank χ^(2)=4.076,P=0.043).For SLE patients,PRP,interstitial lung disease,ABCG1 methylation,RVD,SDRA,LRRA,pulmonary arterial width and SLEDAI in death group were higher than survival group(P<0.05),with a lower proportion of NYHA classⅠtoⅡ(P<0.05).For SLE-PH patients,PRP and SLEDAI score in death group were higher than the survival(P<0.05),with a lower proportion of NYHA classⅠtoⅡ(P<0.05).NYHA classⅢtoⅣ,SLEDAI≥20 points and ABCG1 methylation were risk factors for poor prognosis of SLE(P<0.05),and NYHA classⅢtoⅣfor poor prognosis of SLE-PH(P<0.05).Conclusion The methylation levels of ABCG1 and GALNT2 gene promoters are high in SLE-PH patients.ABCG1 methylation will increase risk for poor prognosis of SLE

关 键 词：系统性红斑狼疮 肺动脉高压 ABCG1 GALNT2 启动子 DNA甲基化 预后 

分 类 号：R593.241[医药卫生—内科学]