Zhou Jianhua, Tian Xuefei, Xu Qinru
Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030.
J Huazhong Univ Sci Technolog Med Sci. 2004;24(2):158-61. doi: 10.1007/BF02885418.
This study investigated the relationship between angiotensin-converting enzyme (ACE) gene insertion/deletion polymorphism and the occurrence, severity, prognosis of HSPN. The polymorphism of ACE gene in 103 HSPN cases and 100 healthy children was studied by using the polymerase chain reactions (PCR). Its relation to the clinical manifestation, pathological classification and prognosis of HSPN was analyzed accordingly. The results showed that: (1) there was a significantly higher frequency for DD genotype in HSPN children (P<0.01); (2) DD genotype was more frequently seen in HSPN children with gross hematuria and massive proteinuria (P<0.05), while DI genotype was more common in HSPN children group with renal insufficiency (P<0.05); (3) although mesangial proliferative lesion was most frequently observed in 21 biopsied HSPN children, and DD genotype frequency was still higher in children with severe pathology (Class III IV); (4) II genotype was significantly frequent in HSPN children with complete remission in the follow-up of 32 HSPN children. It was concluded that the deletion allele of ACE gene might play a role, at least to some extent, in the occurrence, deterioration and progression in juvenile HSPN.
本研究探讨血管紧张素转换酶(ACE)基因插入/缺失多态性与紫癜性肾炎(HSPN)的发生、严重程度及预后之间的关系。采用聚合酶链反应(PCR)研究了103例HSPN患儿和100例健康儿童的ACE基因多态性。并据此分析其与HSPN临床表现、病理分级及预后的关系。结果显示:(1)HSPN患儿中DD基因型频率显著更高(P<0.01);(2)肉眼血尿和大量蛋白尿的HSPN患儿中DD基因型更为常见(P<0.05),而肾功能不全的HSPN患儿组中DI基因型更为常见(P<0.05);(3)尽管在21例接受活检的HSPN患儿中最常观察到系膜增生性病变,且严重病理(III、IV级)患儿中DD基因型频率仍较高;( 在32例HSPN患儿的随访中,完全缓解的HSPN患儿中II基因型显著多见。结论:ACE基因的缺失等位基因可能至少在一定程度上在青少年HSPN的发生、恶化及进展中起作用。