新疆哈萨克族、汉族孕妇凝血系统基因，血小板参数与子痫前期的相关研究

发布时间：2018-01-20 16:53

  本文关键词： 凝血因子 凝血酶原 子痫前期 基因多态性 哈萨克族　出处：《新疆医科大学》2016年博士论文　论文类型：学位论文

【摘要】：目的:探讨子痫前期与凝血因子V基因G1691A及凝血酶原基因G20210A多态性的关系。探讨凝血酶原(PT)基因G20210A和凝血因子V(FVL)基因G1691A在胎盘组织的表达水平与新疆哈萨克族(哈族)子痫前期(PE)的关系。探讨并分析凝血酶原基因G20210A、凝血因子V基因G1691A多态性与凝血功能、血小板参数的关系。探讨哈萨克族与汉族患者中凝血酶原基因G20210A、凝血因子V基因G1691A多态性与凝血功能、血小板参数及子痫前期患者的关系的研究。方法:计算机检索PUBMED、EMBASE、Cochrane图书馆(英文),Elsevier science(荷兰)和中国生物医学文献数据库(CBM),查找凝血因子V基因G1691A及凝血酶原基因G20210A多态性与子痫前期发病相关的临床研究,对纳入的文献进行方法学质量评价,应用Stata11.0软件进行Meta分析。收集2013年1月至2015年12月在新疆医科大学第一附属医院住院的PE患者100例,其中哈族50例,汉族50例;对照组哈族50例,汉族50例。采用聚合酶链式反应一限制性片段长度多态性(PCR-RFLP)技术检测PT基因G20210A及FVL基因G1691A多态性,分析PT基因G20210A及FVL基因G1691A多态性与PE的关联性。采用Logistic回归,探讨哈萨克族与汉族患者中凝血酶原基因G20210A、凝血因子V基因G1691A多态性与凝血功能、血小板参数及子痫前期患者的关系的研究。结果:1.共纳入37个研究,子痫前期病例5048例,对照组6796例。Meta分析结果显示凝血酶原基因G20210A多态性可增加子痫前期的发病率[OR=1.81,95%CI=(1.25-2.63)],其中重度子痫前期[OR=3.02,95%CI=(2.06-4.45)]。同时,凝血因子V基因G1691A多态性亦可增加子痫前期的发病率[OR=1.60,95%CI=(1.28-2.00)],其中重度子痫前期[OR=2.45,95%CI=(1.63-3.69)]。2.PT G20210A在哈萨克族子痫前期族及对照组中的基因型分布GG型[36%(18/50)比22%(11/50)],GA型[44%(22/50)比54%(27/50)]和AA型[20%(10/50)比24%(12/50)];汉族PE患者和对照组之间的比例是:GG型[30%(15/50)比16%(8/50)],GA型[52%(26/50)比62%(31/50)]and AA型[18%(9/50)比22%(11/50)],FVL G1691A在哈萨克族子痫前期及对照组中的基因型分布:GG型[40%(20/50)比26%(13/50)],GA型[48%(24/50)比54%(27/50)]AA型[12%(6/50)比14%(7/50)];汉族PE患者和对照组之间的比例是:GG型[34%(17/50)比28%(14/50)],GA型[50%(25/50)比58%(29/50)]AA型[16%(8/50)比14%(7/50)],差别有统计学意义(哈族:X2=6.069,P=0.048;汉族X2=6.181,P=0.045);这两个组别之间比较有统计学意义(P0.05).FVL基因多态性在PE组和对照组间比较有统计学意义(哈族:X2=5.018,P=0.029;汉族X2=6.67,P=0.025);(P0.05)。3.结果凝血酶原基因G20210A(P=0.001,OR=1.599,95%CI:1.383-1.849)、凝血因子V基因G1691A(P=0.001,OR=2.502,95%CI:1.457-4.298)是哈萨克族PE患者的独立危险因素。凝血酶时间(P=0.012,OR=1.087,95%CI:1.035-1.141)、部分凝血活酶时间(P=0.029,OR=1.386,95%CI:0.184-0.813)、D-二聚体(P=0.031)是哈萨克族PE患者的独立危险因素。凝血酶原时间(P=0.133)、纤维蛋白原(P=0.211)、纤维蛋白原降解产物(P=0.327)、血小板压积((P=0.668)与哈萨克族子痫前期无明显关系。血小板计数(P=0.031,OR=1.699,95%CI:1.181-2.743);血小板平均体积(P=0.001,OR=1.931,95%CI:1.717-2.426);血小板平均分布宽度(P=0.001,OR=2.679,95%CI:2.112-3.142)提示与哈萨克族子痫前期患者的关系明显,是哈萨克族PE患者的独立危险因素。结论:1.凝血因子V基因G1691A及凝血酶原基因G20210A多态性与子痫前期及重度子痫前期的易感性存在明显的相关性。但仍需要大样本高质量的研究进一步论证。2.凝血酶原(PT)基因G20210A和凝血因子V(FVL)基因G1691A在子痫前期的胎盘组织的表达水平明显增高,且新疆哈族的表达水平明显高于汉族。3.凝血酶原基因G20210A、凝血因子V基因G1691A、是哈萨克族PE患者的独立危险因素。凝血酶时间、部分凝血活酶时间、D-二聚体是哈萨克族PE患者的独立危险因素。凝血酶原时间、纤维蛋白原、纤维蛋白原降解产物、血小板压积,与哈萨克族子痫前期间无明显关系。血小板计数;血小板平均体积;血小板平均分布宽度是哈萨克族子痫前期患者的独立危险因素。
[Abstract]:Objective: To investigate the relationship between preeclampsia and coagulation factor V gene G1691A and prothrombin gene G20210A polymorphism (PT). To investigate the prothrombin gene G20210A and coagulation factor V (FVL) gene expression level of G1691A in the placenta with preeclampsia (Xinjiang Kazak Kazak) (PE). The relationship between the study and analysis of the prothrombin gene G20210A, coagulation factor V gene G1691A polymorphism and blood coagulation function, platelet parameters. To investigate the relationship between Kazak and Han patients in prothrombin gene G20210A, coagulation factor V gene G1691A polymorphism and blood coagulation function, study the relationship between platelet parameters and preeclampsia. Methods: We searched PUBMED, EMBASE, Cochrane library, Elsevier (Science (English) Holland) and Chinese biomedical literature database (CBM), find the coagulation factor V gene G1691A and G20210A polymorphism with thrombin primordium and preeclampsia Clinical research of pathogenesis related, the included studies for methodological quality assessment, the application of Stata11.0 software for Meta analysis. 100 PE patients were collected from January 2013 to December 2015 in the First Affiliated Hospital of Xinjiang Medical University, which were 50 cases, 50 cases of Han nationality; 50 patients in control group were 50 cases of Han, polymerase chain reaction restriction. Restriction fragment length polymorphism (PCR-RFLP) to detect the polymorphism of PT gene G20210A and FVL gene of G1691A technology, analysis the association between PT gene G20210A and FVL gene G1691A polymorphism and PE. Logistic regression was used to investigate, Kazak and Han patients in gene G20210A, coagulation factor V gene G1691A polymorphism and blood coagulation function, study the relationship between platelet the parameters and preeclampsia patients. Results: 1. a total of 37 studies, 5048 cases of preeclampsia, 6796 cases in the control group the.Meta analysis results showed that coagulation 琛，

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