El Sebay Hatem M, Safan Manal A, Daoud Ashraf A, Tayel Safaa I, Nouh Mohamed A, El Shafie Shymaa
Department of Medical Biochemistry; Faculty of Medicine, Menoufia University, Shibin El Kom, Egypt.
Department of Tropical Medicine, Faculty of Medicine, Menoufia University, Shibin El Kom, Egypt.
J Gastroenterol Hepatol. 2016 Jan;31(1):235-40. doi: 10.1111/jgh.13066.
Budd-Chiari syndrome (BCS) is defined as obstruction of hepatic venous outflow anywhere from the small hepatic veins to the suprahepatic inferior vena cava. The pathogenesis of BCS is still not fully understood. This study aimed to evaluate the association of factor V Leiden (FVL), Janus kinase 2 (JAK2), prothrombin, and methylene tetrahydrofolate reductase (MTHFR) mutations with primary BCS.
The study was carried out on 35 patients with primary BCS and 15 age and gender matched healthy individuals as a control group. Genotyping of FVL, prothrombin, and MTHFR mutations was determined by GENEQUALITY AB-THROMBO TYPE kit based on the reverse hybridization principle. JAK2 mutation was determined by polymerase chain reaction-restriction fragment length polymorphism.
There was a statistically significant difference between patients and controls regarding FVL, MTHFR C677T, and MTHFR A1298C mutations with odds ratio of 1.83, 2.0, and 1.79, respectively. Hetero MTHFR C677T, hetero FVL, and hetero MTHFR A1298C were the most common etiological factors being responsible for 57.1, 42.9, and 42.9% of primary BCS cases, respectively.
It could be concluded that BCS is a multifactorial disease; in the current study, MTHFR C677T mutation was the most common cause of disease. Identification of one cause of BCS should not eliminate investigations for detection of other etiological factors.
布加综合征(BCS)定义为从小肝静脉到肝上下腔静脉的任何部位的肝静脉流出道梗阻。BCS的发病机制仍未完全阐明。本研究旨在评估凝血因子V莱顿(FVL)、Janus激酶2(JAK2)、凝血酶原和亚甲基四氢叶酸还原酶(MTHFR)突变与原发性BCS的相关性。
本研究纳入35例原发性BCS患者,并选取15例年龄和性别匹配的健康个体作为对照组。基于反向杂交原理,采用GENEQUALITY AB-THROMBO TYPE试剂盒对FVL、凝血酶原和MTHFR突变进行基因分型。采用聚合酶链反应-限制性片段长度多态性检测JAK2突变。
患者与对照组在FVL、MTHFR C677T和MTHFR A1298C突变方面存在统计学显著差异,优势比分别为1.83、2.0和1.79。杂合型MTHFR C677T、杂合型FVL和杂合型MTHFR A1298C是最常见的病因,分别占原发性BCS病例的57.1%、42.9%和42.9%。
可以得出结论,BCS是一种多因素疾病;在本研究中,MTHFR C677T突变是最常见的病因。确定BCS的一个病因不应排除对其他病因的检测。