武汉籍汉族类风湿关节炎患者HLA-DRB1*04、*01基因分型和临床相关性研究

为探讨人类白细胞抗原(HLA)-DRB1*04、*01基因与武汉籍汉族类风湿关节炎(RA)的相关性.采用聚合酶链反应-序列特异性引物法(PCR-SSP),对78例RA患者和126例健康者的HLA-DRB1*01、*04基因型进行检测.结果显示RA患者DR4基因频率为52.5%,对照组为21.6%,2组有显著性差异(P＜0.01),DR1基因频率两组无差异(P＞0.05).RA患者HLA-DR4的主要亚型为DRB1*0405(32.1%)与对照组(6.3%)有显著性差异(P＜0.01).DR4阳性的RA患者的关节压痛数、关节肿胀数、类风湿因子(RF)阳性率、关节侵蚀性病变明显高于DR4阴性的患者(P＜0.01).提示HLA-DR4基因与RA患者易感性及疾病严重性相关,其主要亚型为DRB1*0405、DRB1*0401.DR4基因检测可作为一项病情严重程度及预后判断的辅助指标.

A Study of Association between the HLA-DRB1 * 04,* 01 Alleles Genotyping and Rheumatoid Arthritis from Wuhan Han Nationality

To explore the association between the HLA DR gene and rheumatoid arthritis (RA) in Wuhan in Han nationality of China, the method of DNA amplification with sequence specific primers (PCR SSP) was used to determine HLA DRB 1 *01, *04 genotype in 78 patients with RA and 126 healthy controls from Wuhan of the Han nationality. The frequency of DR 4 was 52.5 % in RA patients and 21.6 % in the healthy controls ( P <0.01). The frequency of DR 1 revealed no difference between the two groups. The DRB 1 *0405 accounted for 32.1 % of DR 4 in RA patients and 6.3 % of DR 4 in controls ( P <0.01). According to the tender joint numbers, the swollen joint numbers, RF ration, joint erosion, the RA patients of DR 4 were higher than those of DR 4 - ( P <0.05). It was showed that the susceptibility and severity of RA was highly associated to the HLA DR 4 ,mainly the DRB 1 *0405, *0401. HLA DR 4 could be taken as a predictive marker for disease severity and a useful prognostic maker in the patients with RA.