HLA基因多态性和生殖道微生物感染与复发性流产的关联  

Association of HLA gene polymorphism and reproductive tract microbial infection with recurrent abortion

作　　者：兰俊 赵俐[1] 林怀忠[1] 隗洪进[1] LAN Jun;ZHAO Li;LIN Huai-zhong;KUI Hong-Jin(Dongguan Maternal and Child Health Hospital,Dongguan,Guangdong 523000,China)

机构地区：[1]东莞市妇幼保健院妇产科,广东东莞523000

出　　处：《中华医院感染学杂志》2023年第12期1861-1865,共5页Chinese Journal of Nosocomiology

基　　金：东莞市社会发展科技重点基金资助项目(202318009359);广东省中医药管理局基金资助项目(20221410)。

摘　　要：目的 分析人类白细胞抗原(HLA)基因多态性、生殖道微生物感染与复发性流产的关系。方法 回顾性分析2018年1月-2021年1月东莞市妇幼保健院妇产科收治的复发性流产(RSA)患者84例临床资料,设为RSA组,另选取同期医院自愿行人工流产的孕妇50例为对照组。微生态检查生殖道微生物;采用实时聚合酶链式反应-限制性片段长度多态性(PCR-RFLP)法检测HLA-G、HLA-C和HLA-DQB1基因多态性。结果 沙眼衣原体(CT)、解脲支原体(UU)和淋球菌(NG)为主要感染病原体,RSA组CT、UU和NG感染阳性率均高于对照组;RSA组14 bp基因杂合子(+14 bp/-14 bp)的基因频率高于对照组(P<0.05);插入纯合子(+14 bp/+14 bp)的基因频率低于正常对照组(P<0.05);RSA组HLA-C1/C2基因型占显著优势(P<0.05),对照组孕妇占优势的基因型为HLA-C1/C1。RSA组HLA-C基因杂合子(HLA-C1/C2)的基因频率高于对照组(P<0.05);纯合子(HLA-C1/C1或HLA-C2/C2)的基因频率均低于正常对照组(P<0.05);RSA组HLA-DQB1*0201等位基因频率高于对照组,HLA-DQB1*0302等位基因频率低于对照组(P<0.05);RSA组HLA-DQB1第57位为非天门冬氨酸的基因型频率高于对照组(P<0.05)。结论 生殖道微生物感染及HLA基因多态性与RSA发生有关。OBJECTIVE To analyze the relationship between polymorphisms of human leukocyte antigen(HLA) gene,microbial infection of the reproductive tract and recurrent spontaneous abortion(RSA).METHODS The clinical data of 84 patients with RSA admitted to the department of Obstetrics and Gynecology of Dongguan Materal and Child Health Hospital between Jan.2018 and Jan.2021 were retrospectively analyzed,the patients were assigned as the RSA group,and another 50 pregnant women who voluntarily underwent abortion in the hospital during the same period were enrolled as the control group.The reproductive tract microorganisms were examined by micro-ecology.The polymorphisms of HLA-G,HLA-C and HLA-DQB1 genes were detected by real-time polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP).RESULTS Chlamydia trachomatis(CT),Ureaplasma urealyticum(UU) and Neisseria gonorrhoeae(NG) were the main infectious pathogens.The positive rates of CT,UU and NG infection in the RSA group were significantly higher than those in the control group.The gene frequency of 14 bp gene heterozygote(+14 bp/-14 bp) in the RSA group was significantly higher than that in the control group(P<0.05),and gene frequency of inserted homozygote(+14 bp/+14 bp) was significantly lower than that in normal control group(P<0.05).The HLA-C1/C2 genotype was significantly dominant in the RSA group(P<0.05),and the dominant genotype in the control group of pregnant women was HLA-C1/C1.The gene frequency of HLA-C gene heterozygote(HLA-C1/C2) in the RSA group was significantly higher than that in the control group(P<0.05),while gene frequency of homozygote(HLA-C1/C1 or HLA-C2/C2) was significantly lower than that in the control group(P<0.05).The frequency of HLA-DQB1*0201 allele in the RSA group was significantly higher than that in the control group,while frequency of HLA-DQB1*0302 allele was significantly lower than that in the control group(P<0.05).There was no significant difference in frequency of the other alleles between the two groups.The genotype

关 键 词：人类白细胞抗原 基因多态性 微生物感染 复发性流产 沙眼衣原体 淋球菌 解脲支原体 

分 类 号：R714.21[医药卫生—妇产科学]