特发性血小板减少性紫癜患儿HLA-DRB1基因多态性

摘要

Aim: To estimate the relation between human leukocyte antigen-DRBl ( HLA-DRB1 ) and idiopathic thrombocytopenic purpura (ITP) in children. Methods: Peripheral blood samples and stools were collected from 200 children with ITP and 200 normal children. GICA and ABC-ELISA were used to detect the Helicobacter pylori (Hp) antibody in blood and Hp antigen in stool. PCR specific sequence primers( PCR-SSP) was used to identify HLA-DRB1 gene. Results: The frequency of HLA-DRB1 * 07 significantly decreased in ITP children compared with controls(x2 = 5.444,P =0.020). Compared with acute ITP( AITP) , the frequency of HLA-DRB1 * 11 significantly increased in children with chronic ITP (CITP)(x2 = 6.224,P=0.013).The frequencies of HLA-DRB1 * 14 and HLA-DRB1 * 11 in ITP children with Hp infection were higher than those without Hp infection(x2 =8.602 and 8.794,all P were 0.003). Conclusion:HLA-DRB1 *07 seems to be aprotective factor to against ITP. HLA DRB1 * 11 may play an important role in CITP. HLA-DRB1 * 11 and HLA-DRB1 * 14 seems to predict susceptibility to Hp infection in ITP children.%目的:探讨人类白细胞抗原DRB1(HLA-DRB1)基因多态性与儿童特发性血小板减少性紫癜(ITP)的关系.方法:分别采用胶体金法和ABC-ELISA法检测200例ITP患儿和200例对照全血幽门螺杆菌(Hp)-1gG抗体和粪便Hp抗原;序列特异性引物PCR(PCR-SSP)法对HLA-DRB1基因进行分型.结果:①ITP组与对照组HLA-DRB1*07基因频率分别为6.5%和13.5%,差异有统计学意义(χ2=5.444,P=0.020).②急性ITP(AITP)与慢性ITP(CITP)患儿HLA-DRB1*11基因频率分别为9.3%和22.0%,差异有统计学意义(χ2=6.224,P均为0.003).③Hp阳性与Hp阴性ITP患儿HLA-DRB1*14和HLA-DRB1*11基因频率分别为16.0%和3.8%及22.3%和7.5%,差异有统计学意义(χ2=8.602和8.794,P均=0.003).结论:①HLA-DRB1*07可能对儿童ITP的发病具有保护作用.②具有HLA-DRB1*11基因型的患儿易发展为CITP.③HLA-DRB1*14和HLA-DRB1*11基因可能是儿童ITP患儿Hp感染的易感因素.