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目的研究HLA-B基因多态性与严重急性呼吸综合征冠状病毒(SARS-CoV)易感性的关系,以揭示遗传因素在严重急性呼吸综合征(SARS)发病中的作用。方法采用病例-对照的研究设计,运用PCR-SBT方法,对43例SARS康复后病人、30例高危医护人员对照和62例健康对照的HLA-B位点等位基因型分布进行研究,并根据基因型指定血清型进行分析。运用SPSS11.5软件包进行统计分析,组间比较采用χ2检验,计算比值比(OR)及其95%可信区间(95%CI)。结果与健康人群比较,SARS康复病人HLA-B*51G1和HLA-B*5502基因型以较低频率出现,但两者差异无统计学意义(P=0.08)。同时,与高危人群比较,SARS康复病人HLA-B*51G1基因型出现频率较低,差异也无统计学意义(P=0.07),而HLA-B*130201和HLA-B*5801基因型以较高频率出现(P值分别为0.08和0.08)。血清型结果显示HLA-B血清型B13(P=0.03,OR=4.73,95%CI1.01～21.85)和B35(P=0.04,由于HCW该血清型为0,OR不能计算)为SARS-CoV感染的易感因素,而B07(P=0.01,OR=0.16,95%CI0.03～0.76)、B27(P=0.01,OR=0.16,95%CI0.03～0.76)和B49(P=0.01,由于SARS病人该血清型为0,OR不能计算)为SARS-CoV感染的保护因素。结论HLA-B*51G1和5502基因型可能在SARS发生中起到保护作用,而HLA-B*130201和5801基因型可能是SARS发生的易感因素。而按照血清分型,B13和B35为SARS-CoV感染的易感因素,B07、B27和B49为SARS-CoV感染的保护因素。
Objective To study the relationship between HLA-B gene polymorphism and susceptibility to severe acute respiratory syndrome (SARS-CoV) in order to reveal the role of genetic factors in the pathogenesis of severe acute respiratory syndrome (SARS). Methods A case-control study was conducted to investigate allelic distribution of HLA-B locus in 43 cases of SARS patients, 30 cases of high-risk medical staff and 62 healthy controls by PCR-SBT. Genotypes were assigned serotypes for analysis. SPSS11.5 software package was used for statistical analysis. Chi-square test was used to compare the odds ratios (OR) and its 95% confidence interval (95% CI). Results Compared with healthy people, HLA-B * 51G1 and HLA-B * 5502 genotypes were found in lower frequency in SARS patients, but the difference was not statistically significant (P = 0.08). At the same time, HLA-B * 51G1 genotypes were lower in SARS-rehabilitated patients than those in high-risk groups (P = 0.07), but HLA-B * 130201 and HLA- B * 5801 genotypes were lower High frequencies (P = 0.08 and 0.08, respectively). The serotype results showed that HLA-B serotypes B13 (OR = 4.73, 95% CI1.01-21.85) and B35 (P = 0.04, OR = 0 due to HCW serotype) (P = 0.01, OR = 0.16, 95% CI 0.03 ~ 0.76), B27 (P = 0.01, OR = 0.16, 95% CI 0.03 ~ 0.76) and B49 , OR can not be calculated because SARS patients have serotype 0) is a protective factor against SARS-CoV infection. Conclusion HLA-B * 51G1 and 5502 genotypes may play a protective role in the pathogenesis of SARS, while the HLA-B * 130201 and 5801 genotypes may be susceptible to SARS. According to the serological classification, B13 and B35 are the predisposing factors of SARS-CoV infection. B07, B27 and B49 are the protective factors of SARS-CoV infection.