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目的探讨慢性肾小球肾炎(CGN)与人白细胞抗原(HLA)的相关性。方法以山东省3所省级医院近十年汉族CGN尿毒症患者1073例为病例组,选择中国造血干细胞捐献者资料库山东省分库汉族人7418名无关汉族健康志愿捐献者为对照组,对两组的HLA-Ⅰ、Ⅱ类A、B、DRB1三个位点的基因多态性进行分析比较,探寻上述基因多态性与CGN的关系;并随访了部分携带易感基因的患者,评价其预后。结果病例组中HLA-A23、A25、B15、1340、B53、DRB1*18基因频率显著高于对照组,这些基因可能是CGN尿毒症的易感基因,且随访发现携带该类基因的患者预后较差。病例组中A23-B44-DRB1*18、A25-B15-DRB1*07、A3-B70-DRB1*11、A68-B13-DRB1*04、A11-B10- DRB1*12五个单倍型基因频率显著高于对照组,同时检出HLA-A20、A22、A35、A36、A38、B21、B73、B78等8种低频率基因在对照组中未见表达;病例组中HLA-A32、A33、B50、B58、B60、B71、DRB1*16基因频率显著低于正常对照,这些基因可能是慢性肾小球肾炎尿毒症的保护基因。结论山东省汉族人群CGN与HLA具有较强关联性,且携带可能易感基因的患者肾移植预后较差。
Objective To investigate the relationship between chronic glomerulonephritis (CGN) and human leukocyte antigen (HLA). Methods A total of 1073 Han Chinese patients with CGN uremia in three provincial hospitals in Shandong Province were selected as case group. 7418 Han unrelated Han volunteers from Han nationality in Shandong province were selected as control group, Two groups of HLA-Ⅰ, Ⅱ class A, B, DRB1 three genetic polymorphisms were analyzed and compared to explore the relationship between genetic polymorphisms and CGN; and some patients with susceptibility genes were followed up, the evaluation Its prognosis. Results The frequencies of HLA-A23, A25, B15, 1340, B53 and DRB1 * 18 genes in the case group were significantly higher than those in the control group. These genes may be susceptibility genes for CGN uremia. The prognosis of patients carrying this gene difference. The haplotype frequencies of A23-B44-DRB1 * 18, A25-B15-DRB1 * 07, A3-B70-DRB1 * 11, A68-B13-DRB1 * 04 and A11-B10-DRB1 * 12 were significantly A32, A35, A36, A38, B21, B73, B78 and other low-frequency genes in the control group showed no expression; HLA-A32, A33, B50, B58, B60, B71, DRB1 * 16 gene frequency was significantly lower than the normal control, these genes may be chronic glomerulonephritis uremia protection gene. Conclusions There is a strong correlation between CGN and HLA in Shandong Han population, and patients with potentially susceptible genes have a poor prognosis in renal transplantation.