【摘要】：目的:探討持續(xù)性變應(yīng)性鼻炎(AR)患者白三烯D4合成酶(LTD4S)基因多態(tài)性及其與抗白三烯治療反應(yīng)性的關(guān)系。方法:選取持續(xù)性AR患者150例,其中男87例,女63例,年齡(38±14)歲。健康對照者146例,其中男78例,女68例,年齡(39±12)歲。應(yīng)用聚合酶鏈反應(yīng)-限制性片段長度多態(tài)性方法(RELP)檢測LTD4SA-444C基因多態(tài)性及等位基因的頻率。治療組采用白三烯受體拮抗劑孟魯司特單藥治療4周,分別于治療前后采用酶聯(lián)免疫吸附法測定尿白三烯D4(LTD4)水平,根據(jù)癥狀、體征積分變化及尿LTD4水平評價抗白三烯治療的反應(yīng)性。應(yīng)用多元方差分析法檢測LTD4S基因-444C等位基因頻率與治療反應(yīng)性的相關(guān)性。結(jié)果:①AR組中LTD4S基因-444位點基因型AA、AC/CC頻率分別為70.7%(106/150)和29.3%(44/150),等位基因A、C頻率分別為67.3%(101/150)和32.7%(49/150),健康對照組LTD4S基因-444位點基因型AA、AC/CC頻率分別為76.7%(112/146)和23.3%(34/146),等位基因A、C頻率分別為74.0%(108/146)和26.0%(38/146),差異無統(tǒng)計學(xué)意義。②150例AR患者中,基因型AC/CC患者較AA型患者年輕(分別為35±9、50±8歲,F=5.891,P0.05),起病較早(分別為31±4、46±6歲,F=6.985,P0.05),病程較長(分別為8.7±2.1、3.1±2.0年,F=11.43,P0.05),癥狀評分(8.2±0.2、4.8±0.3.t=6.95,P0.05)、體征評分(7.3±3.3、3.4±5.1,t=8.89,P0.05)更高,2組差異有統(tǒng)計學(xué)意義。③150例AR患者應(yīng)用孟魯司特鈉治療4周后,基因型AC/CC患者對抗白三烯治療的反應(yīng)性優(yōu)于AA型(F=11.01,P0.05),2組患者治療反應(yīng)的差異與體內(nèi)LTD4水平有關(guān),與臨床癥狀、體征相關(guān)。結(jié)論:襄陽地區(qū)漢族人群中LTD4SA-444C基因多態(tài)性可能與持續(xù)性AR患者應(yīng)用白三烯受體拮抗劑的臨床反應(yīng)性相關(guān)。
[Abstract]:Aim: to investigate the relationship between leukotriene D 4 synthase (LTD4S) gene polymorphism and anti leukotriene therapeutic reactivity in patients with persistent allergic rhinitis (AR). Methods: 150 patients with persistent AR were selected, including 87 males and 63 females, aged (38 鹵14) years. 146 healthy controls, including 78 males and 68 females, aged (39 鹵12) years. Polymerase chain reaction-restriction fragment length polymorphism (RELP) was used to detect the frequency of LTD4SA-444C gene polymorphism and allele. The treatment group was treated with montelukast, a leukotriene receptor antagonist, for 4 weeks. The levels of urinary leukotriene D _ 4 (LTD4) were measured by enzyme-linked immunosorbent assay before and after treatment. To evaluate the reactivity of anti-leukotriene therapy with the changes of sign score and urinary LTD4 level. Multivariate variance analysis was used to detect the correlation between the allele frequency of LTD4S gene -444C and the therapeutic reactivity. Results in the 1: 1AR group, the frequencies of LTD4S gene -444 locus genotype AAC / CC were 70.7% (106 / 150) and 29.3% (44 / 150), respectively, and the alleles were 67.3% (101 / 150) and 32.7% (49 / 150), respectively. In the healthy control group, the frequencies of LTD4S -444 locus genotype AAAAC / CC were 76.7% (112 / 146) and 23.3% (34 / 146), respectively, and the frequencies of the alleles were 67.3% (101 / 150) and 32.7% (49 / 150), respectively. The difference was 74.0% (108 / 146) and 26.0% (38 / 146), and there was no significant difference among 2150 AR patients. The patients with genotype AC/CC were younger than those with AA type (35 鹵9 鹵50 鹵8 years old, P 0.05), the onset of disease was earlier (31 鹵4 46 鹵6 years old), the course of disease was longer (8.7 鹵2.1 鹵3.1 鹵2.0 years), the symptom score was (8.2 鹵0.24.8 鹵0.3tl 鹵6.95 P 0.05), the physical sign score (7.3 鹵3.3 鹵5.1tl) was higher than that of the two groups (P < 0.05). There was significant difference between the two groups. Patients were treated with montelukast sodium for 4 weeks. The response to leukotriene therapy in genotype AC/CC patients was better than that in AA group (FV 11.01P 0.05). The difference of therapeutic response was related to the level of LTD4 in the body, and was related to clinical symptoms and signs. Conclusion: the polymorphism of LTD4SA-444C gene in Xiangyang Han population may be related to the clinical reactivity of leukotriene receptor antagonists in patients with persistent AR.
【作者單位】： 湖北文理學(xué)院附屬醫(yī)院;襄陽市中心醫(yī)院藥學(xué)部;襄陽市中心醫(yī)院耳鼻咽喉科;襄陽市中心醫(yī)院檢驗科;
【基金】：科技部十一五科技支撐計劃子課題(No:2007BAI18B15) 湖北省自然科學(xué)基金(No:2011CDB320) 湖北省衛(wèi)生廳項目(No:JX5C26)
【分類號】：R765.21

【參考文獻(xiàn)】

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