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目的人类白细胞抗原(human leucocyte antigen,HLA)参与肠道炎性息肉的病理生理过程,通过HLA介导的炎症因子与功能性肠道障碍(functional bowel disorder,FBD)发生机制有关。文中研究老年患者肠道炎性息肉与HLA-DQA1-DQB1连锁基因单倍体的相关性。方法选择68例正常老年人作为对照组,114例老年肠道炎性息肉合并FBD患者作为研究组。按照FBD在功能性胃肠病罗马Ⅲ标准中分型,所有肠道炎性息肉患者按序数分成4个亚组,包括肠易激综合征(n=30)、功能性腹胀(n=28)、功能性便秘(n=28)、功能性腹泻(n=28)。采用序列特异性引物聚合酶链反应(PCR sequence-spe-cific primer,PCR-SSP)技术,检测各组患者循环血HLA-DQA1-DQB1连锁基因单倍体的频率,并进行各组比较分析。结果研究组各HLA-DQA1-DQB1连锁基因单倍体的检出率与对照组比较,无显著性差异(P>0.05,RR<4),但研究组功能性腹泻亚组DQA1*0301-DQB1*0602连锁基因单倍体检出率(3.57%)低于对照组(20.59%),存在显著性差异(P<0.01,RR=0.14)。结论 DQA1*0301-DQB1*0602连锁基因单倍体与老年人肠道炎性息肉合并功能性腹泻有一定关联,HLA-DQA1-DQB1连锁基因单倍体在老年人肠道炎性息肉患者中分布与正常人之间存在差异。
Objective Human leucocyte antigen (HLA) is involved in the pathophysiological process of inflammatory bowel polyps. HLA-mediated inflammatory cytokines are involved in the pathogenesis of functional bowel disorder (FBD). In this paper, the association of intestinal polyps with HLA-DQA1-DQB1 haplotype in elderly patients was studied. Methods Sixty-eight normal elderly patients were selected as the control group, and 114 elderly patients with inflammatory polyp and FBD were selected as the study group. All patients with inflammatory bowel disease were divided into 4 subgroups according to FBD in the Roman Ⅲ standard of functional gastrointestinal disease, including irritable bowel syndrome (n = 30), functional abdominal distension (n = 28) , Functional constipation (n = 28), functional diarrhea (n = 28). The frequencies of HLA-DQA1-DQB1 haplotypes in circulating blood of each group were detected by PCR-S-PCR, and the comparative analysis of each group was made. Results The detection rate of HLA-DQA1-DQB1 linkage haplogroups in the study group was not significantly different from that in the control group (P> 0.05, RR <4). However, the functional diarrhea subgroup DQA1 * 0301-DQB1 * The haplotype detection rate of 0602 linkage gene (3.57%) was lower than that of control group (20.59%), there was a significant difference (P <0.01, RR = 0.14). Conclusion The haplotypes of DQA1 * 0301-DQB1 * 0602 are associated with functional diarrhea in intestinal polyps in the elderly. HLA-DQA1-DQB1 haplotypes are distributed in the elderly patients with inflammatory polyps There are differences with normal people.