血清淀粉样蛋白A水平及其基因多态性与特发性静脉血栓栓塞症的相关性研究

摘要

目的:探讨血清淀粉样蛋白A(SAA)水平及其基因多态性与维、汉族特发性静脉血栓栓塞症(VTE)之间的关系.方法:采用病例-对照研究,选择维族VTE162例、汉族VTE184例,性别和年龄匹配的健康体检者维族203例、汉族230例,应用ELESA法检测SAA水平、PCR-PFLP技术检测SAA基因rs12218和rs4638289多态性.结果:维、汉民族VTE患者吸烟所占比例均较高,经回归分析得出,吸烟是VTE的独立危险因素.维吾尔族VTE组的体质指数(BMI)为[(27.7±4.1)vs.(25.8±4.2)kg/m2]、腰围[(85.1±9.6)vs.(81.5±9.9)cm]高于对照组,且差异有统计学意义(P＜0.05);而汉族VTE组的腰围[(83.3±10.1)vs.(80.0±10.6) cm]高于对照组,且差异有统计学意义(P＜0.05),而BMI[(24.9±3.6)vs.(24.5±3.4) kg/m2]在两组间无差别;腹型肥胖是维、汉族VTE患者的危险因素.汉族人群中,VTE组的C反应蛋白(CRP)高于正常对照组(5.06vs.3.64 mg/L),且差异有统计学意义[(P＜0.05),校正后,CRP是VTE的独立危险因素.维、汉族VTE组的SAA水平均升高,分别为(6.3±2.9)vs.(5.5±2.4) mg/L和(8.3±3.7)vs.(6.8±3.3)mg/L,P＜0.05],经回归分析显示SAA水平不是维、汉族VTE的独立危险因子.SAA基因rs12218和rs4638289多态性在维、汉民族中的分布不存在民族异质性;SAA基因rs12218和rs4638289多态性在VTE组和正常对照组分布差异无统计学意义,均不是VTE的危险因子.结论:腹型肥胖、吸烟是维、汉族VTE共同的危险因素;CRP水平是汉族VTE的危险因素;VTE患者的SAA水平升高,但不是维、维汉族VTE的独立危险因素,且SAA基因多态性不是特发性VTE的危险因素.%Objective:To investigate the relationships between SAA levels and SAA gene polymorphisms with idiopathic VTE.Methods:A case-control study,Uygur VTE 162 cases、Han VTE 184 cases,healthy sex and age matched Uygur 203 cases、Han 230 cases,using ELESA method to detect SAA level,the SAA gene rs12218 and rs4638289 polymorphisms were detected by PCR-PFLP technique.Results:Smoking in Uygur and Han VTE groups were higher,by logistic analysis,smoking is an independent risk factor of VTE.In Uygur,the BMI of VTE [(27.7 ± 4.1) vs.(25.8 ± 4.2) kg/m2],waist circumference [(85.1 ± 9.6) vs.(81.5± 9.9) cm] higher than the control groups,and the difference were statistically significant (P ＜ 0.05);In Han,waist circumference [(83.3 ± 10.1)vs.(80.0 ± 10.6) cm] higher than the control group,and the difference was statistically significant(P ＜ 0.05),but BMI [(24.9 ± 3.6) vs.(24.5 ± 3.4) kg/m2] were no differences between the two groups.In the Han population,the CRP level of VTE group was higher than that in control group (5.06 vs.3.64mg/L);CRP is an independent risk factor for VTE in Han by logistic regression analysis.Compared with the control group,SAA levels of VTE groups were increased in Uygur and Han groups,respectively [(6.3 ±2.9)vs.(5.5 ±2.4)mg/L and(8.3 ±3.7)vs.(6.8 ±3.3) mg/L],but SAA level is not an independent risk factor for VTE in Uygur and Han nationalities.The distributions of rs12218 and rs4638289 gene polymorphisms in Uygur and Han nationalities do not exist among ethnic groups.SAA rs12218 and rs4638289 gene polymorphisms are not risk factors for VTE.Conclusion:Waist circumference and smoking are risk factors for VTE in Uygur and Han ethnic groups.CRP is a risk factor for VTE in Han population.SAA levels and thire gene polymorphisms are not correlated with VTE.However,the further expansion of the sample size detection and analysis may have new discoveries.