实用医学杂志 ›› 2020, Vol. 36 ›› Issue (24): 3363-3368.doi: 10.3969/j.issn.1006⁃5725.2020.24.012

• 临床研究 • 上一篇    下一篇

CD40⁃rs1883832、CD40⁃rs4810485基因多态性与乙肝肝硬化遗传易感性及预后的关系

张茂华 ,罗金键, 王康康, 汪秀梅, 吴慧丽   

  1. 郑州大学附属郑州中心医院消化内科(郑州450007)

  • 出版日期:2020-12-25 发布日期:2021-01-19
  • 通讯作者: 罗金键 E⁃mail:e519228@163.com
  • 基金资助:
    河南省医学科技攻关计划(编号:2018020723)

Relationship between genetic polymorphism of CD40⁃rs1883832 and CD40⁃rs4810485 and genetic suscepti⁃bility and prognosis of hepatitis B cirrhosis

ZHANG Maohua,LUO Jinjian,WANG Kangkang,WANG Xiu⁃mei,WU Huili
  

  1. Department of Gastroenterology,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,China
  • Online:2020-12-25 Published:2021-01-19
  • Contact: LUO Jinjian E⁃mail:e519228@163.com

摘要:

目的 探讨 CD40⁃rs1883832、CD40⁃rs4810485 基因多态性与乙肝肝硬化遗传易感性及预后 的关系。方法 选取 2015 2 月至 2018 1 月本院收治的 480 乙肝肝硬化患者、480 例乙肝病毒感染者及 480 例健康体检者,分别设为病例组、乙肝组和健康组。采用聚合酶链反应⁃限制性片段长度多态性(PCR⁃ RFLP)法分析 CD40⁃rs1883832、CD40⁃rs4810485 基因多态性,对比 3 组两位点基因型分布和等位基因频率, 随访病例组患者 2 年生存情况,采用 Cox 回归分析法分析 CD40⁃rs1883832、CD40⁃rs4810485 基因多态性对 乙肝肝硬化患者预后的影响;采用 Kaplan⁃Meier 法分析两位点不同基因型患者生存情况,并进行 Log⁃rank 检验。结果 病例组CD40⁃rs1883832 T等位基因频率高于健康组和乙肝组,且乙肝组高于健康组(P < 0.05); 3 CD40⁃rs4810485 G 等位基因频率比较,差异无统计学意义(P > 0.05)。Cox 回归分析显示,CD40⁃ rs1883832 位点 CT、TT 基因型是影响乙肝肝硬化预后的独立危险因素(HR=1.682、2.588,P<0.05);CD40⁃ rs4810485 基因位点 CG、GG 基因型与乙肝肝硬化预后无明显相关性(P > 0.05)。480 例乙肝肝硬化患者 2 年死亡率 16.55%(72/145),其中 CD40⁃rs1883832 基因携带 C 等位基因(CC + CT)患者死亡 33 例,非携带 C 等位基因(TT)患者死亡39例,经Kaplan⁃Meier 生存曲线分析,CC + CT 基因型患者与TT 基因型患者生存曲 线比较,差异有统计学意义(P < 0.05);CD40⁃rs4810485 基因携带 C 等位基因(CC + CG)患者死亡 51 例,非携带 C 等位基因(GG)患者死亡 21 例,经 Kaplan⁃Meier 生存曲线分析,CC + CG 基因型患者与 GG 基因型患 者生存曲线比较,差异无统计学意义(P > 0.05)。结论 CD40⁃rs1883832 基因多态性与乙肝肝硬化遗传易 感性及预后关系密切,且与CC + CT 基因型相比,TT 

关键词:


Abstract:

Objective To explore the relationship between CD40⁃ rs1883832 and CD40⁃ rs4810485 gene polymorphisms and the genetic susceptibility and prognosis of hepatitis B cirrhosis. Methods 480 patients with hepatitis B cirrhosis,480 patients with hepatitis B virus and 480 healthy medical examiners admitted to our hospital from February 2015 to January 2018 were selected as case group,hepatitis B group and healthy group,respectively. The polymorphisms of CD40⁃rs1883832 and CD40⁃rs4810485 were analyzed by polymerase chain reaction⁃restric⁃ tion fragment length polymorphism(PCR⁃RFLP)method,and the genotype distribution and allele frequency of the two loci were compared of the 3 groups. Follow⁃up the 2⁃year survival of the patients in the case group,the Cox regression analysis method was used to analyze the effect of CD40⁃rs1883832 and CD40⁃rs4810485 gene polymor⁃ phisms on the prognosis of patients with hepatitis B cirrhosis. The Kaplan⁃Meier method was used to analyze the survival of two patients with different genotypes,and log⁃rank test was performed. Results The frequency of CD40⁃ rs1883832 T allele in the case group was higher than that in the healthy group and hepatitis B group,and the hepa⁃ titis B group was higher than the healthy group(P < 0.05). There was no significant difference in the frequency of CD40⁃ rs4810485 G allele between the 3 groups(P > 0.05). Cox regression analysis showed that the CT and TT genotypes of CD40⁃rs1883832 were independent risk factors affecting the prognosis of hepatitis B cirrhosis(HR = 1.682,2.588,P < 0.05)with the prognosis of hepatitis B cirrhosis(P > 0.05). The two⁃year mortality rate of 480 patients with hepatitis B cirrhosis was 16.55%(72/145). Among them,thirty ⁃three patients with CD40⁃ rs1883832 gene carrying C allele (CC + CT)died,and patients without C allele(TT)died 39 cases. According to Kaplan⁃Meier survival curve anal⁃ ysis,the difference between the 2⁃year survival curves of patients with CC + CT genotype and TT genotype was statistically significant(P < 0.05). Fifty⁃one patients with CD40⁃rs4810485 gene carrying C allele(CC+CG)died and patients without C allele(GG)died 21 cases.. According to Kaplan⁃Meier survival curve analysis,there was no statistically significant difference between the CC + CG genotype patient and the GG genotype patient 2⁃year survival curve(P > 0.05). Conclusion The CD40⁃rs1883832 gene polymorphism is closely related to the genetic susceptibility and prognosis of hepatitis B cirrhosis,and compared with the CC + CT genotype,patients with TT 

Key words: hepatitis B cirrhosis, gene polymorphism, CD40, genetic susceptibility, prognosis