本文關(guān)鍵詞： 凝血因子 凝血酶原 子癇前期 基因多態(tài)性 哈薩克族　出處：《新疆醫(yī)科大學(xué)》2016年博士論文　論文類型：學(xué)位論文

【摘要】：目的:探討子癇前期與凝血因子V基因G1691A及凝血酶原基因G20210A多態(tài)性的關(guān)系。探討凝血酶原(PT)基因G20210A和凝血因子V(FVL)基因G1691A在胎盤組織的表達(dá)水平與新疆哈薩克族(哈族)子癇前期(PE)的關(guān)系。探討并分析凝血酶原基因G20210A、凝血因子V基因G1691A多態(tài)性與凝血功能、血小板參數(shù)的關(guān)系。探討哈薩克族與漢族患者中凝血酶原基因G20210A、凝血因子V基因G1691A多態(tài)性與凝血功能、血小板參數(shù)及子癇前期患者的關(guān)系的研究。方法:計(jì)算機(jī)檢索PUBMED、EMBASE、Cochrane圖書館(英文),Elsevier science(荷蘭)和中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(CBM),查找凝血因子V基因G1691A及凝血酶原基因G20210A多態(tài)性與子癇前期發(fā)病相關(guān)的臨床研究,對納入的文獻(xiàn)進(jìn)行方法學(xué)質(zhì)量評價(jià),應(yīng)用Stata11.0軟件進(jìn)行Meta分析。收集2013年1月至2015年12月在新疆醫(yī)科大學(xué)第一附屬醫(yī)院住院的PE患者100例,其中哈族50例,漢族50例;對照組哈族50例,漢族50例。采用聚合酶鏈?zhǔn)椒磻?yīng)一限制性片段長度多態(tài)性(PCR-RFLP)技術(shù)檢測PT基因G20210A及FVL基因G1691A多態(tài)性,分析PT基因G20210A及FVL基因G1691A多態(tài)性與PE的關(guān)聯(lián)性。采用Logistic回歸,探討哈薩克族與漢族患者中凝血酶原基因G20210A、凝血因子V基因G1691A多態(tài)性與凝血功能、血小板參數(shù)及子癇前期患者的關(guān)系的研究。結(jié)果:1.共納入37個(gè)研究,子癇前期病例5048例,對照組6796例。Meta分析結(jié)果顯示凝血酶原基因G20210A多態(tài)性可增加子癇前期的發(fā)病率[OR=1.81,95%CI=(1.25-2.63)],其中重度子癇前期[OR=3.02,95%CI=(2.06-4.45)]。同時(shí),凝血因子V基因G1691A多態(tài)性亦可增加子癇前期的發(fā)病率[OR=1.60,95%CI=(1.28-2.00)],其中重度子癇前期[OR=2.45,95%CI=(1.63-3.69)]。2.PT G20210A在哈薩克族子癇前期族及對照組中的基因型分布GG型[36%(18/50)比22%(11/50)],GA型[44%(22/50)比54%(27/50)]和AA型[20%(10/50)比24%(12/50)];漢族PE患者和對照組之間的比例是:GG型[30%(15/50)比16%(8/50)],GA型[52%(26/50)比62%(31/50)]and AA型[18%(9/50)比22%(11/50)],FVL G1691A在哈薩克族子癇前期及對照組中的基因型分布:GG型[40%(20/50)比26%(13/50)],GA型[48%(24/50)比54%(27/50)]AA型[12%(6/50)比14%(7/50)];漢族PE患者和對照組之間的比例是:GG型[34%(17/50)比28%(14/50)],GA型[50%(25/50)比58%(29/50)]AA型[16%(8/50)比14%(7/50)],差別有統(tǒng)計(jì)學(xué)意義(哈族:X2=6.069,P=0.048;漢族X2=6.181,P=0.045);這兩個(gè)組別之間比較有統(tǒng)計(jì)學(xué)意義(P0.05).FVL基因多態(tài)性在PE組和對照組間比較有統(tǒng)計(jì)學(xué)意義(哈族:X2=5.018,P=0.029;漢族X2=6.67,P=0.025);(P0.05)。3.結(jié)果凝血酶原基因G20210A(P=0.001,OR=1.599,95%CI:1.383-1.849)、凝血因子V基因G1691A(P=0.001,OR=2.502,95%CI:1.457-4.298)是哈薩克族PE患者的獨(dú)立危險(xiǎn)因素。凝血酶時(shí)間(P=0.012,OR=1.087,95%CI:1.035-1.141)、部分凝血活酶時(shí)間(P=0.029,OR=1.386,95%CI:0.184-0.813)、D-二聚體(P=0.031)是哈薩克族PE患者的獨(dú)立危險(xiǎn)因素。凝血酶原時(shí)間(P=0.133)、纖維蛋白原(P=0.211)、纖維蛋白原降解產(chǎn)物(P=0.327)、血小板壓積((P=0.668)與哈薩克族子癇前期無明顯關(guān)系。血小板計(jì)數(shù)(P=0.031,OR=1.699,95%CI:1.181-2.743);血小板平均體積(P=0.001,OR=1.931,95%CI:1.717-2.426);血小板平均分布寬度(P=0.001,OR=2.679,95%CI:2.112-3.142)提示與哈薩克族子癇前期患者的關(guān)系明顯,是哈薩克族PE患者的獨(dú)立危險(xiǎn)因素。結(jié)論:1.凝血因子V基因G1691A及凝血酶原基因G20210A多態(tài)性與子癇前期及重度子癇前期的易感性存在明顯的相關(guān)性。但仍需要大樣本高質(zhì)量的研究進(jìn)一步論證。2.凝血酶原(PT)基因G20210A和凝血因子V(FVL)基因G1691A在子癇前期的胎盤組織的表達(dá)水平明顯增高,且新疆哈族的表達(dá)水平明顯高于漢族。3.凝血酶原基因G20210A、凝血因子V基因G1691A、是哈薩克族PE患者的獨(dú)立危險(xiǎn)因素。凝血酶時(shí)間、部分凝血活酶時(shí)間、D-二聚體是哈薩克族PE患者的獨(dú)立危險(xiǎn)因素。凝血酶原時(shí)間、纖維蛋白原、纖維蛋白原降解產(chǎn)物、血小板壓積,與哈薩克族子癇前期間無明顯關(guān)系。血小板計(jì)數(shù);血小板平均體積;血小板平均分布寬度是哈薩克族子癇前期患者的獨(dú)立危險(xiǎn)因素。
[Abstract]:Objective: To investigate the relationship between preeclampsia and coagulation factor V gene G1691A and prothrombin gene G20210A polymorphism (PT). To investigate the prothrombin gene G20210A and coagulation factor V (FVL) gene expression level of G1691A in the placenta with preeclampsia (Xinjiang Kazak Kazak) (PE). The relationship between the study and analysis of the prothrombin gene G20210A, coagulation factor V gene G1691A polymorphism and blood coagulation function, platelet parameters. To investigate the relationship between Kazak and Han patients in prothrombin gene G20210A, coagulation factor V gene G1691A polymorphism and blood coagulation function, study the relationship between platelet parameters and preeclampsia. Methods: We searched PUBMED, EMBASE, Cochrane library, Elsevier (Science (English) Holland) and Chinese biomedical literature database (CBM), find the coagulation factor V gene G1691A and G20210A polymorphism with thrombin primordium and preeclampsia Clinical research of pathogenesis related, the included studies for methodological quality assessment, the application of Stata11.0 software for Meta analysis. 100 PE patients were collected from January 2013 to December 2015 in the First Affiliated Hospital of Xinjiang Medical University, which were 50 cases, 50 cases of Han nationality; 50 patients in control group were 50 cases of Han, polymerase chain reaction restriction. Restriction fragment length polymorphism (PCR-RFLP) to detect the polymorphism of PT gene G20210A and FVL gene of G1691A technology, analysis the association between PT gene G20210A and FVL gene G1691A polymorphism and PE. Logistic regression was used to investigate, Kazak and Han patients in gene G20210A, coagulation factor V gene G1691A polymorphism and blood coagulation function, study the relationship between platelet the parameters and preeclampsia patients. Results: 1. a total of 37 studies, 5048 cases of preeclampsia, 6796 cases in the control group the.Meta analysis results showed that coagulation 琛，

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