关节病型银屑病临床与实验研究
发布时间：2018-07-20 13:20
【摘要】：第一部分关节病型银屑病流行病学和临床特征的研究 第一章关节病型银屑病在银屑病中构成比及临床特征研究 背景国外研究显示关节病型银屑病(PsA ,psoriatic arthritis)约占银屑病患者的6-48%不等。而我国1984年全国银屑病流行病调查显示PsA在银屑病中仅占0.69%。 目的对PsA在银屑病中的构成比(患病率)及其临床特征进行研究。 方法在皮肤科门诊开展一项横断面研究,对成年银屑病患者的PsA患病情况进行筛查,并对临床资料进行登记。研究方法结合关节情况问卷、体格检查、影像学检查以及风湿科会诊的方法,采用CASPAR标准诊断。登记内容包括性别、年龄、银屑病发病年龄、发病时间、皮损类型、病情及严重程度、发病部位、银屑病家族史,以及受累关节的发病时间、发病情况和体格检查、辅助检查结果等。 结果共有1928例患者参加本项研究,其中256例(13.3%)具有关节症状的患者进行了相应的体格检查和X线、CT、高频超声等辅助检查。对于160例有关节症状而既往未经风湿科医生诊断的患者,请风湿科会诊,以排除其他关节病变。根据CASPAR诊断标准,共确认112例PsA患者,占所有银屑病患者的5.8%,其中103例患者(92%)为首次诊断。PsA患者中87例(77.7%)伴炎症性外周关节炎,30例(26.8%)患者伴脊柱受累, 30例(26.8%)患者伴有附着点炎。12例(10.7%)患者外周关节和脊柱关节均受累。PsA相对特征性的远端指间关节炎和指/趾炎,分别在27例(24.1%)和15例(13.4%)患者中出现。PsA患者和非PsA的银屑病患者两组比较显示,PsA患者年龄稍大( 44.9 vs.35.5 years ),其皮损发病年龄略晚(30.8 vs. 27.7岁),伴晚发型银屑病(皮损晚于40岁出现)比例略高于非PsA患者(23.2% vs.15.6%)。PsA患者的银屑病病程较非PsA患者长(14.1 vs 7.8年),PASI评分(9.68 vs. 6.01)和伴有红皮病型皮损的比例(4.5% vs. 0.9%)均高于非PsA患者,且伴指甲损害(46.4% vs. 21.0%)和头皮损害的比例亦高于非PsA患者(90.2% vs. 76.4%)。 结论PsA占银屑病患者的5.8%,在银屑病患者中并非少见,且多数患者处于漏诊状态。广大皮肤科医生应提高对该病的重视和认识程度,以及时准确诊断和治疗患者,预防畸残的发生。 第二章关节病型银屑病少见临床类型的研究 第一节SAPHO综合征22例临床分析 背景SAPHO综合征即滑膜炎、痤疮、脓疱病、骨肥厚、骨炎综合征。该病的范畴和PsA存在交叉。 目的对该病的临床特点进行研究。 方法对22例SAPHO综合征患者的临床资料进行登记并分析。 结果本组病例男7例,女15例,皮损出现平均年龄45岁,骨关节受累平均年龄44岁。皮损表现为掌跖脓疱病者21例,暴发性痤疮者1例。骨关节受累中前胸壁受累19例,外周关节者4例,骶髂关节受累2例。其中10例患者关节受累早于皮损发生,9例患者皮损早于关节受累,3例患者皮损与关节受累同时出现。关节受累与皮损出现平均间隔2.7年,最长达20年。 结论皮肤科就诊的SAPHO综合征患者以中年、女性多见。掌跖脓疱病和前胸壁骨关节受累是最常见的临床表现。 第二节远端指间关节炎型关节病型银屑病14例分析 背景远端指间关节炎型(distal interphalangeal predominant, DIP)PsA在临床上相对少见。 目的对DIP型PsA的临床特点进行研究。 方法对门诊PsA患者的临床资料进行登记,对首发类型为DIP型的14例PsA患者的临床资料进行分析。 结果本组病例平均发病年龄41岁(23~59岁),男:女为4:3。所有患者皮损均早于关节炎发生,平均发病间隔为13年。所有患者头皮均受累,受累关节指/趾伴甲损害者10例(71.4%)。随着病程的进展,14例中有8例患者出现DIP关节外的其他关节受累,临床分型亦出现变化。10例患者曾被误诊,延迟诊断时间平均为6年。 结论皮损早发于关节炎、头皮损害及甲受累与DIP型PsA密切相关。PsA临床分型随着时间的变化而变化, Moll和Wright临床分型的意义有待于进一步研究。该病临床误诊和延迟诊断现象严重,广大医生需提高对该病的认识。 第二部分关节病型银屑病易感基因研究 第一章以银屑病GWAS结果为基础的关节病型银屑病易感基因研究 背景PsA易感基因尚未明确。近期银屑病GWAS成功发现多个银屑病易感基因位点,其中多数位点与PsA的关系尚不明了。 目的对GWAS研究发现的银屑病易感基因位点在PsA、不伴有关节炎的银屑病(PsC,psoriasis cutaneous only)及对照样本中进行关联研究。 方法对30个区域46个SNP,以379例PsA、595例PsC及1181例对照为样本,以Sequenom为平台进行基因分型,并采用Cochran-Armitage趋势检验的方法进行关联分析。采用Cochran's Q和I~2方法对PsA和PsC之间、以及脊柱型PsA和外周关节型PsA之间的异质性进行分析。 结果本研究发现ERAP1基因( rs151823, p =2.82×10~(-6), OR=1.47)、IL28RA基因(rs4649203, p =6.14×10~(-6), OR=0.66)、GJB2基因(rs3751385, p= 6.59×10~(-4), OR=1.33)与PsA相关,并在中国人群PsA样本再次证实了TNIP1基因(rs17728338, p=1.84E×10~(-8) OR=1.98)和IL12B基因(rs2546890,p =4.20×10~(-7) ,OR=1.52)与PsA的相关性。亦在PTTG1、IL1、NOS2、IL23A等基因位点发现PsA的提示关联信号(p0.05)。再次证实了IL28RA基因(rs4649203,p= 2.64×10~(-6) ,OR= 0.70)、ERAP1基因(rs151823, p=2.72×10~(-6),OR=1.39)、TNIP1基因(rs=17728338 p=5.29×10~(-5) , OR=1.59)、IL12B基因(rs2546890, p= 5.21E×10~(-4) ,OR=1.28)与PsC的相关性。异质性分析发现PsA和PsC在ZNF816A基因(Q检验P值为0.04,I2 =75.97%)存在异质性。 结论ERAP1、IL28RA、GJB2、TNIP1、IL12B等基因是PsA和PsC共有的易感基因。ZNF816A基因可能是PsC特有的易感基因,与PsA无关。 第二章以强直性脊柱炎、类风湿性关节炎GWAS结果为基础的关节病型银屑病易感基因研究 背景PsA与强直性脊柱炎、类风湿性关节炎在临床表现、组织病理等方面具有某些共性,且以往研究证实这些疾病易感基因间存在交叉。 目的对近期GWAS研究发现的类风湿性关节炎、强直性脊柱炎易感基因SNP位点在PsA、PsC及对照样本进行基因分型和关联研究。 方法共选择29个区域的36个SNP,在379例PsA、595例PsC及806例健康对照样本中进行基因分型,并采用Cochran-Armitage趋势检验的方法进行关联分析。采用Cochran's Q和I2检验的方法对PsA和PsC、以及脊柱型PsA和外周关节型PsA之间的异质性进行分析。 结果强直性脊柱炎易感基因ERAP1(rs27037,p=6.66×10~(-5),OR=1.43)和易感区域21q22.2(rs rs2242944,P=1.07×10~(-3), OR=0.72)与PsA显著相关。强直性脊柱炎的易感基因IL23R(rs1004819,p=4.58×10~(-3),OR=1.28 )、2p15区域( rs10865331 , p=7.00×10~(-3) , OR=1.28 )及类风湿性关节炎的易感基因KIF5A-PIP4K2C(rs1678542,p=3.66×10~(-2),OR=0.81)与PsA具有提示关联信号。ERAP1基因与PsC亦显著相关。21q22.2区域、IL23R基因与PsC无相关性。PsA亚型分析显示强直性脊柱炎的易感基因IL23R(rs11209032)与脊柱型PsA相关(p=1.57×10~(-3),OR= 1.52),而在仅伴有外周关节炎PsA中无阳性意义(p=5.53×10~(-1),OR=1.07)。而类风湿性关节炎易感基因AFF3、KIF5A-PIP4K2C、7q32.3区域与外周关节型PsA组存在提示关联信号,与脊柱组无相关性。 结论ERAP1基因是PsA、PsC和强直性脊柱炎共有易感基因。21q22.2区域是PsA和强直性脊柱炎共有易感位点。脊柱型PsA与强直性脊柱炎可能具有某些共同的遗传学背景,而外周关节型PsA则与类风湿性关节炎可能具有共同的遗传学背景。
[Abstract]:Part one epidemiological and clinical characteristics of psoriasis arthropathy
Chapter one: the constituent ratio and clinical characteristics of psoriasis arthropathy in psoriasis
Background foreign studies have shown that PsA (psoriatic arthritis) accounts for approximately 6-48% in patients with psoriasis. In China, the National Psoriasis epidemiological survey in 1984 showed that PsA accounted for only 0.69%. in psoriasis.
Objective to study the constituent ratio (prevalence) and clinical characteristics of PsA in psoriasis.
Methods a cross-sectional study was carried out in the Department of dermatology in the Department of dermatology to screen the prevalence of PsA in adult patients with psoriasis, and to register the clinical data. The research methods were combined with the joint situation questionnaire, physical examination, imaging examination, and the methods of consultation in the Department of rheumatism, and were diagnosed by the standard of CASPAR. The registration contents include sex, age, and silver chip. Age, time of disease, type of skin lesion, condition and severity, location of the disease, family history of psoriasis, time of onset of involvement of joints, morbidity and physical examination, auxiliary examination results, etc.
Results a total of 1928 patients were enrolled in this study, of which 256 (13.3%) patients with joint symptoms were examined with corresponding physical examination and X-ray, CT, and high frequency ultrasound. For 160 patients with joint symptoms but not previously diagnosed by a department of rheumatism doctor, the Department of rheumatism consultation was requested to exclude other joint lesions. According to the diagnosis of CASPAR A total of 112 patients with PsA were identified, accounting for 5.8% of all psoriasis patients, of which 103 patients (92%) were first diagnosed with.PsA with inflammatory peripheral arthritis, 30 (26.8%) with spinal involvement, 30 (26.8%) patients (26.8%) with attachment point inflammation (10.7%), the peripheral joints and spinal joints were involved in.PsA relative characteristics. Sexual distal interphalangeal arthritis and finger / phalanges were compared in 27 (24.1%) and 15 (13.4%) patients with.PsA and non PsA psoriasis. The age of PsA patients was slightly older (44.9 vs.35.5 years). The age of the lesions was slightly late (30.8 vs. 27.7 years old), and the proportion of late psoriasis (late at 40 years old) was slightly higher than that of the late type of psoriasis. The course of psoriasis in non PsA patients (23.2% vs.15.6%) was longer than that of non PsA patients (14.1 vs 7.8 years), the PASI score (9.68 vs. 6.01) and the proportion of skin lesions with erythroderma (4.5% vs. 0.9%) were higher than those in non PsA patients, and the proportion of nail damage (46.4% vs. 21%) and head skin damage was also higher than that of non PsA patients (90.2% vs. 76.4%).
Conclusion PsA is 5.8% of psoriasis patients. It is not rare in psoriasis patients and most of the patients are in a missed diagnosis. Doctors in the General Department of Dermatology should improve the importance and understanding of the disease, and diagnose and treat patients accurately and prevent the occurrence of malformation.
The second chapter is a rare clinical type of psoriasis arthropathy.
Clinical analysis of 22 cases of SAPHO syndrome in the first section
Background SAPHO syndrome is synovitis, acne, impetigo, osteosarc and osteitis syndrome. There is a cross between PsA and the disease.
Objective to study the clinical characteristics of the disease.
Methods the clinical data of 22 patients with SAPHO syndrome were registered and analyzed.
Results there were 7 males and 15 females. The average age of skin lesions was 45 years old and the average age of bone and joint involvement was 44 years. There were 21 cases of palmar and plantar pustular disease and 1 cases of fulminant acne. 19 cases of anterior chest wall involvement in bone joint involvement, 4 cases of peripheral joint and 2 cases of sacroiliac joint involvement in the joint involvement, 10 cases of joint involvement earlier than skin lesions, 9 cases. The lesions were earlier than the joint involvement. The lesions and joint involvement occurred in 3 patients. The average interval between joint involvement and skin lesions was 2.7 years, the longest being 20 years.
Conclusion SAPHO syndrome in Department of dermatology is more common in middle-aged women than in women. Palmoplantar impetigo and anterior chest wall bone and joint involvement are the most common clinical manifestations.
Analysis of 14 cases of second cases of distal interphalangeal arthritis type psoriasis
Background distal interphalangeal predominant (DIP) PsA is relatively rare in clinic.
Objective to study the clinical characteristics of DIP type PsA.
Methods the clinical data of outpatients with PsA were registered, and the clinical data of 14 PsA patients with the initial type DIP were analyzed.
Results the average age of onset was 41 years (23~59 years), male: female: all patients with 4:3. were earlier than arthritis, with an average interval of 13 years. All the patients were involved in the scalp, and 10 cases (71.4%) were involved in the joint finger / toe with nail damage. With the progress of the disease, 8 patients in the 14 cases were affected by other joints outside the DIP joint. There was also a change in the type of bed..10 patients were misdiagnosed, and the average time to delay diagnosis was 6 years.
Conclusion the lesion of skin lesions early in arthritis, scalp damage and DIP type PsA closely related to.PsA clinical classification changes with time, the significance of clinical classification of Moll and Wright needs further study. The clinical misdiagnosis and delayed diagnosis of the disease are serious, the general doctors need to improve the understanding of the disease.
The second part is the susceptibility gene of psoriasis arthropathy.
Chapter one is based on psoriasis GWAS findings and the susceptibility genes of psoriasis arthropathy.
Background PsA susceptibility genes are not yet clear. Recently psoriasis GWAS has successfully identified psoriasis susceptibility loci, and the relationship between most loci and PsA is unknown.
Objective to investigate the association of psoriasis susceptibility loci in PsA, PsC, psoriasis cutaneous only, and control samples found in GWAS research.
Methods the genotyping was carried out on the Sequenom platform in 379 cases of PsA, 595 PsC and 1181 cases, and the correlation analysis was carried out by Cochran-Armitage trend test. Cochran's Q and I~2 methods were used to analyze the heterogeneity between PsA and PsC, and PsA and peripheral joint type PsA.
Results the ERAP1 gene (rs151823, P =2.82 x 10~ (-6), OR=1.47) and IL28RA gene (rs4649203, P =6.14 10~) were found to be related to the gene. P =4.20 * 10~ (-7), OR=1.52) and PsA, also in PTTG1, IL1, NOS2, IL23A and so on. The correlation between (rs2546890, p= 5.21E * 10~ (-4), OR=1.28) and PsC. Heterogeneity analysis found that PsA and PsC exist in the ZNF816A gene (Q test P value is 0.04).
Conclusion ERAP1, IL28RA, GJB2, TNIP1, IL12B and other genes are common susceptibility genes of PsA and PsC..ZNF816A gene may be a susceptible gene of PsC, and has nothing to do with PsA.
The second chapter is based on ankylosing spondylitis, rheumatoid arthritis GWAS results based on psoriasis arthropathy susceptibility genes.
Background PsA and ankylosing spondylitis and rheumatoid arthritis have some common features in clinical manifestation and histopathology, and previous studies have confirmed that these diseases cross between susceptible genes.
Objective to study the genotyping and correlation of SNP loci of the susceptible gene of ankylosing spondylitis in PsA, PsC and control samples in the recent GWAS study.
Methods a total of 36 SNP regions of 29 regions were selected for genotyping in 379 cases of PsA, 595 PsC and 806 healthy controls. Correlation analysis was performed by Cochran-Armitage trend test. The heterogeneity of PsA and PsC, and spinal PsA and peripheral joint PsA were analyzed by Cochran's Q and I2 test.
Results the susceptibility gene ERAP1 (rs27037, p=6.66 * 10~ (-5), OR=1.43) and the susceptible region 21q22.2 (RS rs2242944, P=1.07 x 10~ (-3)) are significantly related. The susceptibility gene KIF5A-PIP4K2C (rs1678542, p=3.66 x 10~ (-2), OR=0.81) with PsA has the associated signal that.ERAP1 gene and PsC are also significantly related to.21q22.2 region, IL23R gene and PsC without correlation analysis show that the susceptible gene of ankylosing spondylitis is associated with the spinal column. 1.52, There was no positive significance (p=5.53 x 10~ (-1), OR=1.07) in only peripheral arthritis (PsA). The susceptibility genes of rheumatoid arthritis (AFF3), KIF5A-PIP4K2C, 7q32.3 area and peripheral joint type PsA group were suggested to be related signals, not related to the spinal group.
Conclusion the ERAP1 gene is PsA, PsC and ankylosing spondylitis common susceptible gene.21q22.2 region is the common locus of PsA and ankylosing spondylitis. The spinal PsA and ankylosing spondylitis may have some common genetic background, but the peripheral joint PsA may have the common genetic background with the rheumatoid arthritis.
【学位授予单位】：安徽医科大学
【学位级别】：博士
【学位授予年份】：2011
【分类号】：R758.63
本文编号：2133654
[Abstract]:Part one epidemiological and clinical characteristics of psoriasis arthropathy
Chapter one: the constituent ratio and clinical characteristics of psoriasis arthropathy in psoriasis
Background foreign studies have shown that PsA (psoriatic arthritis) accounts for approximately 6-48% in patients with psoriasis. In China, the National Psoriasis epidemiological survey in 1984 showed that PsA accounted for only 0.69%. in psoriasis.
Objective to study the constituent ratio (prevalence) and clinical characteristics of PsA in psoriasis.
Methods a cross-sectional study was carried out in the Department of dermatology in the Department of dermatology to screen the prevalence of PsA in adult patients with psoriasis, and to register the clinical data. The research methods were combined with the joint situation questionnaire, physical examination, imaging examination, and the methods of consultation in the Department of rheumatism, and were diagnosed by the standard of CASPAR. The registration contents include sex, age, and silver chip. Age, time of disease, type of skin lesion, condition and severity, location of the disease, family history of psoriasis, time of onset of involvement of joints, morbidity and physical examination, auxiliary examination results, etc.
Results a total of 1928 patients were enrolled in this study, of which 256 (13.3%) patients with joint symptoms were examined with corresponding physical examination and X-ray, CT, and high frequency ultrasound. For 160 patients with joint symptoms but not previously diagnosed by a department of rheumatism doctor, the Department of rheumatism consultation was requested to exclude other joint lesions. According to the diagnosis of CASPAR A total of 112 patients with PsA were identified, accounting for 5.8% of all psoriasis patients, of which 103 patients (92%) were first diagnosed with.PsA with inflammatory peripheral arthritis, 30 (26.8%) with spinal involvement, 30 (26.8%) patients (26.8%) with attachment point inflammation (10.7%), the peripheral joints and spinal joints were involved in.PsA relative characteristics. Sexual distal interphalangeal arthritis and finger / phalanges were compared in 27 (24.1%) and 15 (13.4%) patients with.PsA and non PsA psoriasis. The age of PsA patients was slightly older (44.9 vs.35.5 years). The age of the lesions was slightly late (30.8 vs. 27.7 years old), and the proportion of late psoriasis (late at 40 years old) was slightly higher than that of the late type of psoriasis. The course of psoriasis in non PsA patients (23.2% vs.15.6%) was longer than that of non PsA patients (14.1 vs 7.8 years), the PASI score (9.68 vs. 6.01) and the proportion of skin lesions with erythroderma (4.5% vs. 0.9%) were higher than those in non PsA patients, and the proportion of nail damage (46.4% vs. 21%) and head skin damage was also higher than that of non PsA patients (90.2% vs. 76.4%).
Conclusion PsA is 5.8% of psoriasis patients. It is not rare in psoriasis patients and most of the patients are in a missed diagnosis. Doctors in the General Department of Dermatology should improve the importance and understanding of the disease, and diagnose and treat patients accurately and prevent the occurrence of malformation.
The second chapter is a rare clinical type of psoriasis arthropathy.
Clinical analysis of 22 cases of SAPHO syndrome in the first section
Background SAPHO syndrome is synovitis, acne, impetigo, osteosarc and osteitis syndrome. There is a cross between PsA and the disease.
Objective to study the clinical characteristics of the disease.
Methods the clinical data of 22 patients with SAPHO syndrome were registered and analyzed.
Results there were 7 males and 15 females. The average age of skin lesions was 45 years old and the average age of bone and joint involvement was 44 years. There were 21 cases of palmar and plantar pustular disease and 1 cases of fulminant acne. 19 cases of anterior chest wall involvement in bone joint involvement, 4 cases of peripheral joint and 2 cases of sacroiliac joint involvement in the joint involvement, 10 cases of joint involvement earlier than skin lesions, 9 cases. The lesions were earlier than the joint involvement. The lesions and joint involvement occurred in 3 patients. The average interval between joint involvement and skin lesions was 2.7 years, the longest being 20 years.
Conclusion SAPHO syndrome in Department of dermatology is more common in middle-aged women than in women. Palmoplantar impetigo and anterior chest wall bone and joint involvement are the most common clinical manifestations.
Analysis of 14 cases of second cases of distal interphalangeal arthritis type psoriasis
Background distal interphalangeal predominant (DIP) PsA is relatively rare in clinic.
Objective to study the clinical characteristics of DIP type PsA.
Methods the clinical data of outpatients with PsA were registered, and the clinical data of 14 PsA patients with the initial type DIP were analyzed.
Results the average age of onset was 41 years (23~59 years), male: female: all patients with 4:3. were earlier than arthritis, with an average interval of 13 years. All the patients were involved in the scalp, and 10 cases (71.4%) were involved in the joint finger / toe with nail damage. With the progress of the disease, 8 patients in the 14 cases were affected by other joints outside the DIP joint. There was also a change in the type of bed..10 patients were misdiagnosed, and the average time to delay diagnosis was 6 years.
Conclusion the lesion of skin lesions early in arthritis, scalp damage and DIP type PsA closely related to.PsA clinical classification changes with time, the significance of clinical classification of Moll and Wright needs further study. The clinical misdiagnosis and delayed diagnosis of the disease are serious, the general doctors need to improve the understanding of the disease.
The second part is the susceptibility gene of psoriasis arthropathy.
Chapter one is based on psoriasis GWAS findings and the susceptibility genes of psoriasis arthropathy.
Background PsA susceptibility genes are not yet clear. Recently psoriasis GWAS has successfully identified psoriasis susceptibility loci, and the relationship between most loci and PsA is unknown.
Objective to investigate the association of psoriasis susceptibility loci in PsA, PsC, psoriasis cutaneous only, and control samples found in GWAS research.
Methods the genotyping was carried out on the Sequenom platform in 379 cases of PsA, 595 PsC and 1181 cases, and the correlation analysis was carried out by Cochran-Armitage trend test. Cochran's Q and I~2 methods were used to analyze the heterogeneity between PsA and PsC, and PsA and peripheral joint type PsA.
Results the ERAP1 gene (rs151823, P =2.82 x 10~ (-6), OR=1.47) and IL28RA gene (rs4649203, P =6.14 10~) were found to be related to the gene. P =4.20 * 10~ (-7), OR=1.52) and PsA, also in PTTG1, IL1, NOS2, IL23A and so on. The correlation between (rs2546890, p= 5.21E * 10~ (-4), OR=1.28) and PsC. Heterogeneity analysis found that PsA and PsC exist in the ZNF816A gene (Q test P value is 0.04).
Conclusion ERAP1, IL28RA, GJB2, TNIP1, IL12B and other genes are common susceptibility genes of PsA and PsC..ZNF816A gene may be a susceptible gene of PsC, and has nothing to do with PsA.
The second chapter is based on ankylosing spondylitis, rheumatoid arthritis GWAS results based on psoriasis arthropathy susceptibility genes.
Background PsA and ankylosing spondylitis and rheumatoid arthritis have some common features in clinical manifestation and histopathology, and previous studies have confirmed that these diseases cross between susceptible genes.
Objective to study the genotyping and correlation of SNP loci of the susceptible gene of ankylosing spondylitis in PsA, PsC and control samples in the recent GWAS study.
Methods a total of 36 SNP regions of 29 regions were selected for genotyping in 379 cases of PsA, 595 PsC and 806 healthy controls. Correlation analysis was performed by Cochran-Armitage trend test. The heterogeneity of PsA and PsC, and spinal PsA and peripheral joint PsA were analyzed by Cochran's Q and I2 test.
Results the susceptibility gene ERAP1 (rs27037, p=6.66 * 10~ (-5), OR=1.43) and the susceptible region 21q22.2 (RS rs2242944, P=1.07 x 10~ (-3)) are significantly related. The susceptibility gene KIF5A-PIP4K2C (rs1678542, p=3.66 x 10~ (-2), OR=0.81) with PsA has the associated signal that.ERAP1 gene and PsC are also significantly related to.21q22.2 region, IL23R gene and PsC without correlation analysis show that the susceptible gene of ankylosing spondylitis is associated with the spinal column. 1.52, There was no positive significance (p=5.53 x 10~ (-1), OR=1.07) in only peripheral arthritis (PsA). The susceptibility genes of rheumatoid arthritis (AFF3), KIF5A-PIP4K2C, 7q32.3 area and peripheral joint type PsA group were suggested to be related signals, not related to the spinal group.
Conclusion the ERAP1 gene is PsA, PsC and ankylosing spondylitis common susceptible gene.21q22.2 region is the common locus of PsA and ankylosing spondylitis. The spinal PsA and ankylosing spondylitis may have some common genetic background, but the peripheral joint PsA may have the common genetic background with the rheumatoid arthritis.
【学位授予单位】：安徽医科大学
【学位级别】：博士
【学位授予年份】：2011
【分类号】：R758.63
【参考文献】
相关期刊论文 前4条
1 张蔚;李海刚;范苗静;吕志强;沈溪明;何欣欣;;Connexin 32和26在非小细胞肺癌中的表达及其与预后的关系[J];癌症;2009年02期
2 张江林,张振春,黄烽;以关节炎为首发表现的银屑病关节炎的临床特征[J];中华风湿病学杂志;2003年04期
3 魏华,李小峰,王晓霞,王彩虹,张莉芸,王来远;SAPHO综合征一例报道并文献复习[J];中华风湿病学杂志;1999年02期
4 唐玉,杨蓉娅,王文岭,胡绍强,李大伟;前胸壁综合征一例[J];中华皮肤科杂志;2000年02期
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