HLA-DR7在增殖性糖尿病视网膜病变中表达的研究

发布时间：2018-04-27 07:17

  本文选题：T2DM + HLA-DR　； 参考：《山西医科大学》2010年硕士论文

【摘要】： 背景与目的：随着生活方式和饮食结构的变化,糖尿病(Diabetes Mellitus, DM)患病率逐渐升高,糖尿病视网膜病变(Diabetic Retinopathy, DR)作为糖尿病的最常见和最严重的并发症之一也随之升高。糖尿病视网膜病变为四大致盲眼之一,也是五大死亡原因之一,严重影响患者的生活质量与社会经济的发展。糖尿病视网膜病变的发病机制复杂,其确切的发病机制目前尚不清楚,但个体对糖尿病视网膜病变的易感性越来越受到关注,基因对糖尿病视网膜病变发生发展的影响的研究已成为目前国内外研究的热点。 本研究旨在分析HLA-DR在2型糖尿病并发增殖性糖尿病视网膜病变(proliferative diabetic retinopathy, PDR)患者中的表达和HLA-DR7对糖尿病视网膜病病变发生发展的影响,并探讨PDR的遗传易感因素,为临床PDR的治疗和预防提供科学依据,同时也为大量DM患者克服社会心理问题提供依据。 方法：随机选取在山西医科大学第一医院眼科门诊就诊和住院治疗的山西省汉族2型糖尿病病程大于10年未并发糖尿病视网膜病变的患者30例作为病例对照组,选取T2DM并发PDR的患者30例作为病例组,30例健康人做为正常对照组作为研究对象。抽取外周血4ml并提取DNA,对HLA-DR3、DR7、DR11基因进行PCR扩增及基因频率的测定。诊断由临床检查确诊包括眼底检查和FFA检查及OCT等检查。对采用SPSS16.0软件包对数据进行统计学分析,以p≤0.05为统计学有意义。 结果：HLA-DR7在病例对照组者中的平均值为88.53±8.31,在病例组中的平均值为18.88±0.82; HLA-DR3, DR11频率在病例组中的平均值分别为80.55±3.55,84.15±6.51,在正常对照组中频率平均值分别为14.48±0.182,27.86±1.415. HLA-DR3、DR7、DR11在NDM组,DM组和PDR各组中的表达比较均p0.001,差异有统计学意义。 结论：HLA-DR7在山西汉族T2DM病程大于10年未并发的DR的患者中表达增高,提示HLA-DR7对PDR的发生发展可能有保护作用；HLA-DR3在PDR中表达增高,提示PDR有明显的遗传易感倾向。
[Abstract]:Background & objective: with the change of life style and diet structure, the prevalence rate of diabetes mellitus Mellitus (DM) is increasing, and diabetic retinopathy (DR) is one of the most common and serious complications of diabetes mellitus. Diabetic retinopathy is one of the four blind eyes and one of the five leading causes of death, which seriously affects the quality of life and the development of social economy. The pathogenesis of diabetic retinopathy is complex, and its exact pathogenesis is still unclear, but the susceptibility of individual to diabetic retinopathy has been paid more and more attention. The effect of gene on the development of diabetic retinopathy has become a hot topic at home and abroad. The purpose of this study was to investigate the expression of HLA-DR in type 2 diabetic patients with proliferative diabetic retinopathy, PDR) and the effect of HLA-DR7 on the development of diabetic retinopathy, and to explore the genetic predisposing factors of PDR. To provide scientific basis for the treatment and prevention of clinical PDR, and also for a large number of DM patients to overcome psychosocial problems. Methods: thirty patients with type 2 diabetes mellitus in Shanxi Han nationality who had not complicated with diabetic retinopathy for more than 10 years were randomly selected as the control group. Thirty patients with T2DM complicated with PDR were selected as case group and 30 healthy persons as control group. 4ml was extracted from peripheral blood and DNA was extracted. HLA-DR3 DR7 DR11 gene was amplified by PCR and the gene frequency was determined. The diagnosis was confirmed by clinical examination, including fundus examination, FFA examination and OCT examination. SPSS16.0 software package was used for statistical analysis of the data, p 鈮，

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