摘要
为探讨血管紧张素转换酶（ＡＣＥ）基因多态性与狼疮性肾炎（ＬＮ）之间的关系，应用聚合酶链反应（ＰＣＲ）方法对１４４例ＬＮ患者和１５０名正常人ＡＣＥ基因多态性的分布进行了观察，并结合临床病理及随访资料进行了分析。发现ＬＮ患者ＤＤ基因型显著高于正常人（Ｐ＜０．０１），而Ｉ基因型则明显低于正常人（Ｐ＜０．０１），ＤＩ基因型在两组人群中无统计学差异（Ｐ＞０．０５）；ＡＣＥ基因在ＤＩ基因型伴血尿、Ⅳ型ＬＮ、ＬＮ活动、新月体形成和中、重度间质肾小管损害的ＬＮ患者中明显增高，而ＤＤ基因型与ＬＮ患者临床、病理特征之间无相关关系；长期随访结果显示，肾功能恶化组患者ＤＩ基因型的发生频率明显高于肾功能稳定组，而ＤＤ基因型在两组之间无明显差异（Ｐ＞０．０５）。提示ＬＮ患者ＡＣＥ基因ＤＤ基因型的发生频率明显高于正常人，ＤＩ基因型与ＬＮ病情严重性及不良预后相关。
The renin angiotensin system(RAS) is now well established as an important determinant in the progression of renal damage. The level of plasma angiotensin converting enzyme(ACE) is genetically determined and this gene effect is associated with insertion(I)/deletion(D) polymorphism in intron 16 of ACE gene.It has been reported that DD genotype of ACE gene is associated with a poor outcome in patients with IgA nephropathy and trend to develop renal damage in diabetic mellitus.In this study,the correlation between ACE gene I/D polymorphism and the clinical features of lupus nephritis(LN) was determined in 144 LN patients and 150 normal controls by PCR.72 LN patients were followed up for more than two years.It was found that the DD genotype was significantly higher in LN patients than in normal controls ( P <0.01),while the II genotype was much less in LN( P <0.01). There was no significant difference in DI genotype frequency between LN patients and normal control( P >0.05).Patients with hematuria,type Ⅳ LN,activation of LN,crescentic formation and severe tubulo interstitial lesions showed an excess of the DI genotype.However,the DD genotype was not associated with the clinical and pathological characteristics of LN.To assess whether ACE genotype influence the progression of LN, we compared the clinical and pathological findings in patients of different genotype subgroups. There was no significant difference in blood pressure,proteinuria,serum creatinine,active index of disease and crescentic formation at presentation among these groups. However,as patients were divided into two groups according to their rate of decline in renal function. We found that patients with progressive renal function damage had a higher frequency of DI genotype than those with stable renal function( P <0.01). It is conclude that patients with LN the DIated with the severity and genotype was associ the poor prognosis in patients with LN.
出处
《中华内科杂志》
CAS
CSCD
北大核心
1997年第7期461-464,共4页
Chinese Journal of Internal Medicine
基金
军队医药卫生杰出中青年科研基金
