【摘要】 目的探讨难治性慢性丙型肝炎(RCHC)中医证型与人类白细胞抗原(HLA)DP基因单核苷酸多态性(SNP)的相关性,寻找中医证型的分子标志物,为中医辨证提供科学依据。方法收集湖北省中医院收治的200例RCHC住院患者的一般临床资料、中医证型和肝功能指标[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)、清蛋白(ALB)]、丙型肝炎病毒(HCV)RNA、HCV基因型、凝血酶原时间(PT)及血小板计数(PLT)检测结果;同时以100例该院其他科室收治的非RCHC患者为对照,采用双重荧光定量聚合酶链反应(FQ-PCR)技术对RCHC不同中医证型和对照组的HLA-DP基因rs9277535位点进行基因分型,统计分析各数据与中医证型的相关性。结果 200例RCHC中医证型中,肝郁脾虚证最多(100例,50.0%),然后依次是非肝郁脾虚型包括湿热内阻证(48例,24%)、肝肾阴虚证(32例,16.0%)和淤血阻络证(20例,10.0%);肝郁脾虚型与非肝郁脾虚型之间,年龄、肝功能指标和HCV基因型及HCV-RNA水平差异无统计学意义(P>0.05),但PT差异有统计学意义(P<0.05);与对照组相比,RCHC患者的肝郁脾虚组和非肝郁脾虚组的HLA-DP基因rs9277535基因型GG和AA分布差异均无统计学意义(P>0.05)。结论 HLADP基因rs9277535位点基因型GA杂合型和AA突变型在RCHC患者不同中医证型之间差异无统计学意义;但等位基因G和A的分布在肝郁脾虚组和非肝郁脾虚组有差异趋势,值得进一步研究。更多还原

【Abstract】 Objective To investigate the correlation between syndrome types of traditional Chinese medicine(TCM)and HLA-DP gene polymorphisms in patients with refractory chronic hepatitis C(RCHC),and to find suitable molecular markers for TCM syndromes and provide scientific basis for TCM syndrome differentiation.Methods A total of 200 RCHC patients of Hubei Provincial Hospital of Traditional Chinese Medicine were enrolled retrospectively.Their general characteristics,TCM syndromes,data of liver function(ALT,AST,ALP and ALB),HCV RNA,HCV genotypes,PT and PLT were collected.At the same time,100 patients from other departments of the hospital were enrolled as control group.FQ-PCR was used to detect the genotypes of the HLA-DP gene rs9277535 sites of the RCHC patients with different TCM syndromes and the patients of control group.The correlation between the data and TCM syndromes was statistically analyzed.Results Among 200 patients in the study,the pattern of liver-depression and spleen-deficiency was maximum(100 cases,50.0%),while the remaining syndromes were dampness and heat resistance(48 cases,24.0%),yin deficiency of liver and kidney(32 cases,16.0%)and obstruction of collaterals by blood stasis(20 cases,10.0%).For age,data of liver function index and HCV RNA,there was no statistical difference between the liver-depression and spleen-deficiency type and other TCM syndromes(P>0.05).But the difference of PT was significant between liver-depression and spleen-deficiency type and other TCM syndromes(P<0.05).Compared with control group,there was no significant difference between the HLA-DP gene rs9277535 genotype GG and AA in the liver depression spleen deficiency group and the non-liver depression spleen deficiency group in the RCHC patients(P>0.05).Conclusion There was no significant difference between the genotypes of HLA-DP gene rs9277535 genotype GA heterozygous genes and AA homozygous genes in the different TCM syndromes of RCHC patients.However,the distribution of alleles G and A in liver depression spleen deficiency group and non-liver depression spleen deficiency group showed a different trend,which is worthy of further study.更多还原