PLA2R1和HLA基因多态性与膜性肾病中医证型的相关性分析  

Correlation between polymorphisms of PLA2R1 and HLA genes and TCM syndromes of membranous nephropathy

作　　者：郭红英 纪伟超 李曼曼 成雪红 任美芳[4] GUO Hongying;JI Weichao;LI Manman;CHENG Xuehong;REN Meifang(Department of Nephrology of Shijiazhuang Second Hospital,Shijiazhuang,Hebei,China,050000;De-partment of Nephrology,Yiling Hospital of Hebei Province,Shijiazhuang,Hebei,China,050000;Depart-ment of Nephrology,Gaocheng People's Hospital,Shijiazhuang City,Gaocheng,Hebei,China,052160;Nephropathy Department 1 of Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang,Hebei,China,050000)

机构地区：[1]石家庄市第二医院肾内科,河北石家庄050000 [2]河北以岭医院肾内科,河北石家庄050000 [3]石家庄市藁城人民医院肾内科,河北藁城052160 [4]河北省中医院肾病一科,河北石家庄050000

出　　处：《分子诊断与治疗杂志》2024年第3期543-547,552,共6页Journal of Molecular Diagnostics and Therapy

基　　金：河北省中医药管理局科研计划项目(2020082)。

摘　　要：目的 探讨磷脂酶A2受体(PLA2R1)和人类白细胞抗原(HLA)基因多态性与膜性肾病(MN)中医证型的相关性。方法 选取2020年1月至2022年5月石家庄市第二医院收治的148例MN患者作为研究对象,根据不同虚证(肺脾气虚证、气阴两虚证、脾肾阳虚证、肝肾阴虚证)和不同实证(瘀血内阻证、风湿兼夹证、水湿内停证、湿热内蕴证)进行分组,统计所有患者中医证型分布以及PLA2R1(rs35771982、rs3749117)和HLA-DQA1(rs2187668)基因多态性,并分析PLA2R1和HLA基因多态性与中医证型的相关性。结果 气阴两虚证组和脾肾阳虚证组PLA2R1 rs35771982位点G等位基因、PLA2R1rs3749117位点T等位基因水平高于肺脾气虚证组和肝肾阴虚证组,差异有统计学意义(P<0.05);瘀血内阻证组和水湿内停证组PLA2R1 rs35771982位点G等位基因、PLA2R1 rs3749117位点T等位基因水平高于风湿兼夹证组和湿热内蕴证组,差异有统计学意义(P<0.05);不同虚证MN患者HLA-DQA1 rs2187668位点基因型分布比较,差异均无统计学意义(P>0.05);不同实证MN患者HLA-DQA1 rs2187668位点基因型分布比较,差异均无统计学意义(P>0.05)。结论 PLA2R1(rs35771982、rs3749117)基因多态性与MN患者中医证型相关,且虚症(气阴两虚证、脾肾阳虚证)、实证(瘀血内阻证和水湿内停证)患者多数存在PLA2R1位点基因变异,而HLA-DQA1 rs2187668基因多态性与MN患者中医证型无关。Objective To explore the correlation between polymorphisms of phospholipase A2 re-ceptor(PLA2R1)and human leukocyte antigen(HLA)genes and Traditional Chinese Medicine(TCM)syn-dromes of membranous nephropathy(MN).Methods A total of 148 patients with MN were admitted to Shiji-azhuang Second Hospital from January 2020 to May 2022 and were enrolled as the research subjects.The distri-bution of TCM syndromes and polymorphisms of PLA2R1 and HLA genes in all patients was statistically ana-lyzed,and the correlation between polymorphisms of PLA2R1(rs35771982,rs3749117)and HLA-DQA1 rs2187668 genes and TCM syndromes was also analyzed.Results The levels of the G allele at the PLA2R1 rs35771982 locus and the T allele at the PLA2R1 rs3749117 locus in the qi-yin deficiency group and the spleen-kidney yang deficiency group were higher than those in the lung-spleen qi deficiency group and the liver-kid-ney yin deficiency group.These levels were higher in the blood stasis stagnation group and the fluid-dampness internal stagnation group compared to the wind-dampness toxicity accumulation group and the dampness-heat interior retention group.These differences were statistically significant(P<0.05).There was no significant dif-ference in the distribution of genotypes at the HLA-DQA1 rs2187668 locus among MN patients with different deficiency syndromes(P>0.05).However,there was also no significant difference among MN patients with different actual symptoms(P>0.05).Conclusion The polymorphisms of the PLA2R1 gene are correlated with TCM syndromes in patients with MN.Most patients with deficiency symptoms(qi-yin deficiency,spleen-kidney yang deficiency)and actual syndromes(blood stasis stagnation,fluid-dampness internal stagnation)have variations in the PLA2R1 gene(rs35771982、rs3749117).However,the polymorphisms of the HLA-DQA1 gene,specifically rs2187668 are not correlated with TCM syndromes in MN patients.

关 键 词：膜性肾病 磷脂酶A2受体 人类白细胞抗原 中医证型 

分 类 号：R277.5[医药卫生—中医学]