摘要
为了观察ＨＬＡ－ＤＲＢ１等位基因在类风湿关节炎（ＲＡ）临床及发病中的作用，对８６例ＲＡ患者和１０６名正常对照的ＨＬＡ－ＤＲＢ１等位基因进行分型。用序列特异性引物体外基因扩增法测定ＨＬＡ－ＤＲ特异性，用序列特异性寡核苷酸探针进行ＨＬＡ－ＤＲ４亚型的测定。并根据ＨＬＡ－ＤＲＢ１等位基因的分型结果分析ＲＡ的临床表现和血清学特点及其与ＲＡ患者预后的关系。结果表明：同对照组相比，ＲＡ患者中ＨＬＡ－ＤＲ４基因频率明显增高（４８．８％比１７．９％，Ｐ＜０．００１），而ＨＬＡ－ＤＲ５基因频率降低（１６．３％比２７．４％，Ｐ＝０．０６）。ＤＲ４阳性ＲＡ中主要的ＤＲ４亚型为ＨＬＡ－ＤＲＢ１＊０４０５（６１．９％比２１．１％，Ｐ＜０．０１）。在ＤＲ４阳性和ＤＲ４阴性两组患者中，其发病年龄、病程和关节外表现无明显差异，但ＤＲ４阳性组的类风湿因子阳性率高于ＤＲ４阴性组（Ｐ＜０．０５），并且ＤＲ４阳性的ＲＡ患者腕和（或）指关节Ｘ线片分期明显重于ＤＲ４阴性者（Ｐ＜０．０５）。本研究结果表明，我国北方ＲＡ患者和ＨＬＡ－ＤＲ４基因明显相关，其主要亚型为ＨＬＡ－ＤＲＢ１＊０４０５。ＲＡ患者ＨＬＡ－ＤＲ４基因的检测可作为一项有用的预后判断指标。
To explore the role of HLA DRB 1 genes in the development of rheumatoid arthritis (RA) and the correlations between HLA DR alleles and clinical manifestations of patients with RA we studied 86 patients and 106 race matched controls in whom HLA DR typing was perfomed by the method of DNA amplification with sequence specific primers (PCR SSP). The subtypes of HLA DR 4 were determined by the method of hybridization of PCR products with sequence specific oligonucletides (PCR SSO). The absence or presence of HLA DR 4 and its subtypes was evaluated with the clinical and serological characteristics of the patients. Compared with controls, an increased gene frequency of HLA DR 4 (48.8% vs 17.9% , P <0.001) and a decreased frequency of HLA DR 5 (16.3% vs 27.4%, P =0.06) were found. The DRB 1*0405 accounted for 61.9% of DR + 4 RA patients and 21.1% of DR + 4 controls ( P <0.01). There was no difference between the DR + 4 and DR - 4 patients with respect to age, sex, duration of disease, extra articular manifestations including secondary Sjogren′s syndrome. But rheumatoid factor (RF) was associated with HLA DR 4 ( P <0.05). According to the X ray stage, the patients of DR + 4 were more severe than those of DR - 4 ( P <0.05). HLA DR 4 and DR 4 subtype of DRB 1*0405 were related to the development of RA in Chinese. HLA DR 4 can be a useful prognostic marker in the patients with RA.
出处
《中华内科杂志》
CAS
CSCD
北大核心
1997年第2期112-115,共4页
Chinese Journal of Internal Medicine
关键词
类风湿性关节炎
HLA-DR
抗原
Arthritis, rheumatoid Rheumatoid factor HLA DR antigen
