母体KIR与胎儿HLA-C基因的组合形式对子痫前期发病的影响

【目的】探索子宫蜕膜自然杀伤细胞（uNk细胞）免疫球蛋白受体基因（KIR基因）人类白细胞抗原C类分子基因（HLA—C基因）的结合对妊娠期高血压疾病发病的影响。【方法]30例早发型重度子痫前期孕妇及其胎儿作为观察组,20例正常健康孕妇及其胎儿作为对照组,孕妇抽取静脉血进行KIR基因分型,胎儿在出生时抽取脐静脉血进行HLA—C基因分型。【结果】两组HLA—C2的百分率相比差异无显著性（x2=0．67,P〉0．05）。子痫前期组母体KIR基因AA型的有14例,对照组母体AA型有3例,子痫前期组有更多孕妇的KIR基因为AA型,差异有显著性（x2=5．31,P〈0．05）。在子痫前期组,胎儿为HLA-C2型基因共16例,有11例母体KIR基因型为AA型,胎儿为HL艮c1共14例,有3例母体KIR基因型为AA型,在对照组,胎儿为HLA—C2基因型共13例,有3例母体KIR基因型为AA型,比较发现,予痫前期组中,胎儿为HLA—C2基因型时,有更多的母体KIR基因型为AA型,差异有显著性（确切概率P值=0．0109）。子痫前期组与对照组比较,子痫前期组有更多的母体KIR为AA基因型与胎儿HLA—C为C2基因型的结合形式（确切概率P=0．0161）。【结论】母体KIR基因为AA型,所生胎儿HLA—C基因为C2型时,子痫前期发病的风险增加。

Effect of the Combination of Maternal KIR and Fetal HLA-C Genes on the Onset of Preeclampsia

[Objective] To investigate the effect of the combination of maternal KIR and fetal HLA C genes on hypertensive disorders in pregnancy. [Methods] Thirty pregnant women with severe preeclampsia and their fetus were selected as observation group, and 20 normal pregnant women and their fetus were selected as control group. KIR genes for all mothers and HLAC genes for all fetus were typed by PCR-SSP methods. [Results]The frequency of HLA-C2 in preeclampsia fetus and control fetus was 65 % and 53.3 %, respectively, and there was no significant difference between two groups （X2=0.67, P 〉0.05）. KIR genes of 14 mothers in preeclampsia group（ 46. 67%） and 3 mothers in control group（15%） were AA genotype, and there was significant difference between two groups （X2 =5.31, P d0.05）. In preeclampsia group, 16 fetus were HLA C2 genotype and 11 mothers were AA genotype, and 14 fetus were HLA-C1 genotype and 3 mothers were AA genotype. In the control group, 13 fetus were HLA 2 genotype and KIR gene of 3 mothers was AA genotype. By contrast, many mothers in preeclampsia group had KIR AA when their fetus had HLA C2 gene, and there was significant difference（ P =0. 0109）. The concomitant frequency of the mothers of KIR AA and the fetus with HLA C2 in preeclampsia group was more than that in control group （ P = 0. 0161）. [Conclusion] Maternal KIR AA in combination with fetal HLA-C2 may increase the risk of preeelampsia.