难治性慢性丙型肝炎患者中医证型与IL-28B SNP的相关性研究
|
摘要
目的:探讨难治性慢性丙型肝炎(refractory chronic hepatitis C,RCHC)患者中医证型与白细胞介素28B(IL-28B)单核苷酸多态性(SNP)的相关性,探讨中医证候相关合适的分子标志物。方法:收集200例难治性慢性丙型肝炎住院患者的一般临床资料、中医证型和肝功能指标(ALT、AST、ALP和ALB)、HCV基因型及RNA含量、PT及PLT,采用DNA测序技术检测IL-28B SNPs(rs12980275、rs12979860、rs8099917和rs10853728)4个位点的基因型。SPSS 20.0软件分析各数据与中医证型的相关性。结果:200例RCHC患者中医证型中,肝郁脾虚证最多(100例,50%),其余非肝郁脾虚证(肝肾阴虚证、湿热内阻证、瘀血内阻证)共100例,占50%;肝郁脾虚证组患者年龄、肝功能四项和HCV基因型及RNA含量与非肝郁脾虚证组比较,差异均无统计学意义(P>0.05),肝郁脾虚证组患者PT与非肝郁脾虚证组比较,差异有统计学意义(P<0.05);肝郁脾虚证组患者rs12979860 CC基因型的检出率高于非肝郁脾虚证组,差异有统计学意义(P<0.05);两组患者rs12980275 AA基因型、rs8099917 TT基因型和rs10853728CC基因型的检出率比较,差异均无统计学意义(P>0.05)。结论:RCHC中医证型中,肝郁脾虚证最多;PT在不同中医证型中存在差异,RCHC患者中医证型与IL-28B rs12979860 CC基因型相关。
Objective: To investigate the correlation between syndrome types of traditional Chinese medicine and IL-28 B gene polymorphisms in patients with refractory chronic hepatitis C(RCHC), and to find suitable molecular markers for TCM syndromes. Methods: A total of 200 patients were enrolled retrospectively. The general characteristics, TCM syndromes, data of liver function(ALT, AST, ALP and ALB) and HCV RNA were collected. Genotypes of IL-28 B SNPs(rs12980275, rs12979860, rs8099917 and rs10853728) were detected by DNA sequencing. The correlation between TCM syndromes and data were analyzed using the SPSS 20.0. Results:Among 200 patients in the study, the pattern of liver-depression and spleen-deficiency was maximum(100 cases, 50%), the pattern of non-liver-depression and spleen-deficiency was the same amount(100 cases, 50%). For age, data of liver function and HCV prn, there was no statistical difference between the liver-depression and spleen-deficiency type and other TCM syndromes(P>0.05). But the difference of PT was sifnificant between liver-depression and spleen-deficiency type and other TCM syndromes(P<0.05). rsl2979860 genotype CC in liverdepression and spleen-deficiency type was sifnificantly higher than that in other TCM syndromes(P<0.05), there was no statistical difference in rs12980275 genotype AA, rs8099917 genotype TT and rs10853728 genotype CC(P >0.05). Conclusion: Among TCM syndromes of RCHC, liver depression and spleen deficiency are the most common; PT is different in different TCM syndromes. TCM syndromes of RCHC patients are related to IL-28 B rs12979860 CC genotype.
Objective: To investigate the correlation between syndrome types of traditional Chinese medicine and IL-28 B gene polymorphisms in patients with refractory chronic hepatitis C(RCHC), and to find suitable molecular markers for TCM syndromes. Methods: A total of 200 patients were enrolled retrospectively. The general characteristics, TCM syndromes, data of liver function(ALT, AST, ALP and ALB) and HCV RNA were collected. Genotypes of IL-28 B SNPs(rs12980275, rs12979860, rs8099917 and rs10853728) were detected by DNA sequencing. The correlation between TCM syndromes and data were analyzed using the SPSS 20.0. Results:Among 200 patients in the study, the pattern of liver-depression and spleen-deficiency was maximum(100 cases, 50%), the pattern of non-liver-depression and spleen-deficiency was the same amount(100 cases, 50%). For age, data of liver function and HCV prn, there was no statistical difference between the liver-depression and spleen-deficiency type and other TCM syndromes(P>0.05). But the difference of PT was sifnificant between liver-depression and spleen-deficiency type and other TCM syndromes(P<0.05). rsl2979860 genotype CC in liverdepression and spleen-deficiency type was sifnificantly higher than that in other TCM syndromes(P<0.05), there was no statistical difference in rs12980275 genotype AA, rs8099917 genotype TT and rs10853728 genotype CC(P >0.05). Conclusion: Among TCM syndromes of RCHC, liver depression and spleen deficiency are the most common; PT is different in different TCM syndromes. TCM syndromes of RCHC patients are related to IL-28 B rs12979860 CC genotype.
引文
[1]万春平.丙型肝炎病毒流行状况及主要危险因素研究进展[J].齐齐哈尔医学院学报,2015,36(30):1612-4614.
[2]徐东平,李进.慢性丙型肝炎抗病毒治疗研究最新进展[J].传染病信息,2013,26(1):21-24.
[3]薛博瑜.难治性慢性丙型肝炎的中医辨证论治[J].南京中医药大学学报,2015,31(1):1-3.
[4]王成宝,陈逸云,聂红明,等.基于循证医学的慢性丙型肝炎患者病毒基因分型与中医证候之间的关系探讨[J].中西医结合肝病杂志,2014,24(5):259-261.
[5]中华医学会肝病学分会,中华医学会感染病学分会.丙型肝炎防治指南(2015年更新版)[J].中华实验和临床感染病杂志(电子版),2015,9(5):590-607.
[6]中华中医药学会内科肝病专业委员会.病毒性肝炎中医辨证标准[J].中医杂志,1992,33(5):39-40.
[7]陈攸涛,江家骥.丙型肝炎病毒流行现状[J].海峡预防医学杂志,2014,15(5):19-21.
[8]吴伟慎,单爱兰,解晓华,等.乙型和丙型病毒性肝炎高危人群血清学分析[J].中国慢性病预防与控制,2010,18(1):93-94.
[9]陶剑,刘俊,雷华,等.丙型肝炎患者IL28B基因型和HCV基因型对抗病毒治疗的影响[J].世界华人消化杂志,2011,19(22):2372-2375.
[10]蔡潘松善.清化瘀毒、益气养阴法联合干扰素治疗难治性丙型肝炎气虚瘀热证的临床研究[D].南京:南京中医药大学,2017.
[11]刘娟娟.HLA-DP多态性与乙型肝炎病毒感染及其不同结局相关性Meta分析[D].昆明:昆明医科大学,2017.
[12] Jing Chen,Wei Wang,Xiaoguang Li,et al. A metaanalysis of the association between IL28B polymorphisms and infection susceptibility of hepatitis B virus in Asian population[J].BMC Gastroenterology,2015,15(1):1-7.
[13]李京涛,魏海,梁席奇,等.慢性丙型肝炎中医证型与HCV1b亚型NS5A aa变异、IL28BSNP的关系[J].长春中医药大学学报,2015,31(4):762-765.
[2]徐东平,李进.慢性丙型肝炎抗病毒治疗研究最新进展[J].传染病信息,2013,26(1):21-24.
[3]薛博瑜.难治性慢性丙型肝炎的中医辨证论治[J].南京中医药大学学报,2015,31(1):1-3.
[4]王成宝,陈逸云,聂红明,等.基于循证医学的慢性丙型肝炎患者病毒基因分型与中医证候之间的关系探讨[J].中西医结合肝病杂志,2014,24(5):259-261.
[5]中华医学会肝病学分会,中华医学会感染病学分会.丙型肝炎防治指南(2015年更新版)[J].中华实验和临床感染病杂志(电子版),2015,9(5):590-607.
[6]中华中医药学会内科肝病专业委员会.病毒性肝炎中医辨证标准[J].中医杂志,1992,33(5):39-40.
[7]陈攸涛,江家骥.丙型肝炎病毒流行现状[J].海峡预防医学杂志,2014,15(5):19-21.
[8]吴伟慎,单爱兰,解晓华,等.乙型和丙型病毒性肝炎高危人群血清学分析[J].中国慢性病预防与控制,2010,18(1):93-94.
[9]陶剑,刘俊,雷华,等.丙型肝炎患者IL28B基因型和HCV基因型对抗病毒治疗的影响[J].世界华人消化杂志,2011,19(22):2372-2375.
[10]蔡潘松善.清化瘀毒、益气养阴法联合干扰素治疗难治性丙型肝炎气虚瘀热证的临床研究[D].南京:南京中医药大学,2017.
[11]刘娟娟.HLA-DP多态性与乙型肝炎病毒感染及其不同结局相关性Meta分析[D].昆明:昆明医科大学,2017.
[12] Jing Chen,Wei Wang,Xiaoguang Li,et al. A metaanalysis of the association between IL28B polymorphisms and infection susceptibility of hepatitis B virus in Asian population[J].BMC Gastroenterology,2015,15(1):1-7.
[13]李京涛,魏海,梁席奇,等.慢性丙型肝炎中医证型与HCV1b亚型NS5A aa变异、IL28BSNP的关系[J].长春中医药大学学报,2015,31(4):762-765.