广西地区慢性荨麻疹与HLA-DRB1等位基因及血清总IgE的相关性研究

发布时间：2018-01-27 12:33

本文关键词： 慢性荨麻疹等位基因 HLA-DRB1 自体血清皮肤试验　出处：《广西医科大学》2011年硕士论文　论文类型：学位论文

【摘要】：目的探讨广西地区慢性荨麻疹与HLA-DRB1等位基因的相关性。结合慢性荨麻疹患者的自体血清皮肤试验结果和血清总IgE,初步探索它们与HLA-DRB1等位基因遗传易感性的关系。方法1.采用聚合酶链反应-序列特异性引物方法,对144例已确诊的广西地区慢性荨麻疹患者(患者组,汉族64例,壮族80例)和199例正常对照组(汉族95例,壮族104例)进行HLA-DRB1等位基因的分析。 2.对患者组进行自体血清皮肤试验,按试验结果分为阳性组(62例)和阴性组(82例),并对其进行HLA-DRB1等位基因的分析。 3.采用免疫印迹方法检测患者组和正常对照组的血清总IgE含量,并分析其与本实验所检测的HLA-DRB1等位基因的关系。结果 1.汉、壮族患者组与其对照组间HLA-DRB1等位基因频率的比较： (1)在设计的16对HLA-DRB1等位基因序列特异性引物中,汉族患者组和汉族对照组分别检测出13对和16对等位基因,基因频率范围分别为0.78%～25.78%和0.53%～13.68%。其中HLA-DRB1*12、*1401等位基因频率在汉族患者组与汉族对照组间比,差异有统计学意义(Pc0.001,RR=6.715；Pc0.001,RR=28.776). (2)壮族患者组和壮族对照组分别检测出9对和14对等位基因,基因频率范围分别为0.63%～22.50%和0.48%～18.27%。其中HLA-DRB1*1401等位基因频率在壮族患者组与壮族对照组间比,差异有统计学意义(Pc=0.002,RR=4.526)。 (3)HLA-DRB1*01、*1402等位基因在汉族患者组与汉族正常组中均出现,但在壮族患者组与壮族正常组中均未见出现,其频率在汉族患者组与壮族患者组间比,差异均无统计学意义(P0.05)。HLA-DRB1*12、*1305等位基因在汉族患者组中出现但在壮族患者组中未见出现,其中HLA-DRB1*12等位基因频率在汉族患者组与壮族患者组间比,差异有统计学意义(Pc0.001)。 2.自体血清皮肤试验阳性组、阴性组与对照组间HLA-DRB1等位基因频率的比较： HLA-DRB1*01、*1401、*16等位基因频率在三组间比较,差异均有统计学意义(χ2=10.919,Pc=0.032；χ2=35.341,Pc0.001；χ2=12.694,Pc=0.032)。进一步在各组间进行两两比较,仅有HLA-DRB1*1401等位基因频率分别在自体血清皮肤试验阳性组与对照组间比及自体血清皮肤试验阳性组与阴性组间比,差异均有统计学意义(Pc0.001,RR=17.091；Pc0.001,RR=7.200)。 3.患者组与对照组间血清总IgE阳性率的比较：慢性荨麻疹患者组的血清总IgE阳性率为75%,正常对照组的血清总IgE全部为阴性,血清总IgE阳性率在两组间比,差异有统计学意义(P0.001)。自体血清皮肤试验阳性组的血清总IgE阳性率为41.9%,阴性组的血清总IgE全部阳性,血清总IgE阳性率在两组间比,差异有统计学意义(P0.001)。 4.携带与不带HLA-DRB1*1401等位基因的CU患者间血清总IgE阳性率的比较：携带有HLA-DRB1*1401等位基因但自体血清皮肤试验阴性的CU患者组的血清总IgE阳性率为51.2%,而不携带此等位基因且自体血清皮肤试验阴性的CU患者组的血清总IgE阳性率为84.5%,血清总IgE阳性率在两组间比,差异有统计学意义(P0.001)。携带有HLA-DRB1*1401等位基因且自体血清皮肤试验阳性的CU患者组的血清总IgE阳性率为35.5%,而不携带此等位基因但自体血清皮肤试验阳性的CU患者组的血清总IgE阳性率为48.4%,血清总IgE阳性率在两组间比,差异无统计学意义(P0.05)。结论HLA-DRB1*12、*1401等位基因可能与广西地区汉族CU有相关性；HLA-DRB1*1401等位基因可能与广西地区壮族CU有相关性；HLA-DRB1等位基因在广西地区汉、壮族间分布存在差异。HLA-DRB1*1401等位基因可能与广西地区自体血清皮肤试验阳性的CU患者有相关性。CU的发病可能是不同HLA等位基因与环境因素共同作用的结果。
[Abstract]:Objective To investigate the relationship between chronic urticaria and HLA - DRB1 alleles in Guangxi . Combined with the results of autologous serum skin test and serum total IgE in patients with chronic urticaria , the relationship between them and HLA - DRB1 alleles was preliminarily explored . Method 1 . Polymerase chain reaction - sequence specific primer method was used to analyze the HLA - DRB1 alleles in 144 patients with chronic urticaria ( group A , 64 in Han nationality , 80 in Zhuang nationality ) and 199 normal controls ( 95 of Han nationality and 104 Zhuang people ) . 2 . The patients were divided into positive group ( 62 cases ) and negative group ( 82 cases ) according to the test results , and the HLA - DRB1 allele was analyzed . 3 . The serum total IgE levels of patients and normal control groups were determined by Western blotting . The relationship between HLA - DRB1 alleles and HLA - DRB1 alleles was analyzed . Results 1 . Comparison of HLA - DRB1 allele frequencies between Chinese and Zhuang patients and their control groups : ( 1 ) In the 16 pairs of HLA - DRB1 allele specific primers , 13 pairs and 16 pairs of alleles were detected in the Han and Han control groups . The frequencies of the genes were 0.78 % - 25.78 % and 0.53 % - 13.68 % , respectively . ( 2 ) The frequencies of HLA - DRB1 * 1401 allele were 0.63 % - 22.50 % and 0.48 % - 18.27 % , respectively . The frequencies of HLA - DRB1 * 1401 allele were significantly higher in Zhuang patients and Zhuang people ( Pc = 0.002 , RR = 4.526 ) . ( 3 ) HLA - DRB1 * 01 , * 1402 allele appeared in the normal group of Han patients and Han nationality , but there was no statistical significance in the Zhuang people group and Zhuang nationality group ( P0.05 ) . HLA - DRB1 * 12 and * 1305 alleles were not found in the group of Han patients but not in Zhuang people group . 2 . Comparison of HLA - DRB1 allele frequencies between positive and negative groups in autologous serum skin test : The frequencies of HLA - DRB1 * 01 , * 1401 , and * 16 allele were significantly different among the three groups ( 蠂2 = 10.919 , Pc = 0.032 ; 蠂2 = 35.341 , p0.001 ; 蠂2 = 12.694 , Pc = 0.032 ) . The frequencies of HLA - DRB1 * 1401 allele and HLA - DRB1 * 1401 allele frequencies were significantly higher in the positive and negative groups than in the control group and in the control group . The difference was statistically significant ( P < 0.001 , RR = 17.091 , P < 0.001 , RR = 7.200 ) . 3 . Comparison of the positive rate of serum total IgE between the patient group and the control group : The positive rate of total IgE in sera of patients with chronic urticaria was 75 % , and the total IgE in normal control group was negative . The positive rate of total IgE in serum was 41.9 % . 4 . Comparison of the positive rate of serum total IgE in patients with CU without HLA - DRB1 * 1401 allele : The positive rate of total IgE in sera of CU patients with HLA - DRB1 * 1401 allele but negative for autologous serum skin test was 51.2 % , and the positive rate of total IgE in sera of CU patients with negative serum skin test was 84.5 % . The positive rate of serum total IgE in CU patients with HLA - DRB1 * 1401 allele and positive serum skin test was 48.4 % , and the positive rate of total IgE in serum was not statistically significant ( P0.05 ) . Conclusion HLA - DRB1 * 12 , * 1401 allele may be related to the Han CU in Guangxi region . HLA - DRB1 * 1401 allele may be related to Zhuang nationality CU in Guangxi region . HLA - DRB1 * 1401 allele may be related to the distribution of HLA - DRB1 * 1401 allele in Han and Zhuang people in Guangxi region . HLA - DRB1 * 1401 allele may be related to CU patients with positive serum skin test positive in Guangxi region . The pathogenesis of CU may be the result of common effect of different HLA alleles and environmental factors .

【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R758.24

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