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目的探讨血管紧张素转换酶(ACE)、血管紧张素原(AGT)、内皮型一氧化氮合酶(e NOS)基因多态性与特发性膜性肾病(IMN)相关性。方法选取2011年6月至2015年5月在新疆维吾尔自治区人民医院经肾脏病理和临床资料综合确诊的45例维吾尔族IMN患者为IMN组,45例维吾尔族Ig A肾病患者为Ig AN组,45例维吾尔族健康体检者为健康对照,采用直接测序方法检测ACE I/D、AGT M235T、e NOS G894T位点单核苷酸多态性(SNP)。结果 IMN组ACE DD基因型和D等位基因频率分别为26.7%和56.7%,均高于Ig AN组的20.0%和40.0%,D等位基因差异有统计学意义(P<0.05);Ig AN组e NOS GG基因型和G等位基因的频率分别为62.2%,75.6%,均高于健康对照组的26.7%和50.0%,差异均有显著统计学意义(P<0.01);ACE DD基因型的患者24 h蛋白尿(2.99±1.48)g明显高于ACE II基因型(1.57±1.26)g的患者,两组差异有统计学意义(P<0.05),ACE DD基因型的患者血尿(225.25±225.10)万/ml显著高于ACE ID基因型(86.33±141.13)万/ml的患者,两组差异有显著统计学意义(P<0.01);AGT CC基因型的患者血清肌酐(164.53±105.95)μmol/L明显高于AGT TC基因型(99.03±64.11)μmol/L的患者,差异有统计学意义(P<0.05);e NOS GG基因型的患者血清肌酐(172.70±114.73)μmol/L明显高于e NOS GT基因型(97.93±47.12)μmol/L患者,差异有统计学意义(P<0.05)。结论 ACE/AGT/e NOS不是新疆维吾尔族IMN患者的易感基因,但与IMN的进展相关。
Objective To investigate the association of angiotensin converting enzyme (ACE), angiotensinogen (AGT), endothelial nitric oxide synthase (e NOS) gene polymorphism and idiopathic membranous nephropathy (IMN). Methods A total of 45 Uighur IMN patients diagnosed by pathological and clinical data from June 2011 to May 2015 in People’s Hospital of Xinjiang Uygur Autonomous Region were selected as IMN group and 45 Uighur IgA nephropathy patients as Ig AN group. In the case of healthy Uygur healthy subjects, the single nucleotide polymorphisms (SNPs) of ACE I / D, AGT M235T and eNOS G894T were detected by direct sequencing. Results The frequencies of ACE DD genotype and D allele in IMN group were 26.7% and 56.7%, respectively, which were higher than those in Ig AN group by 20.0% and 40.0%, respectively. The allele D was statistically significant (P <0.05) The frequencies of eNOS GG genotype and G allele in AN group were 62.2% and 75.6%, respectively, which were significantly higher than those in healthy control group (26.7% vs 50.0%, P <0.01); ACE DD Patients with genotype 24 h proteinuria (2.99 ± 1.48 g) was significantly higher than ACE II genotype (1.57 ± 1.26) g patients, the difference was statistically significant (P <0.05), ACE DD genotype in patients with hematuria (225.25 ± 225.10) / ml was significantly higher than that of ACE ID genotype (86.33 ± 141.13) / ml, with significant difference between the two groups (P <0.01); serum creatinine ± 105.95) μmol / L was significantly higher than that of the AGT TC genotype (99.03 ± 64.11) μmol / L (P <0.05). Serum creatinine (172.70 ± 114.73) μmol / L was significantly higher than eNOS GT genotype (97.93 ± 47.12) μmol / L, the difference was statistically significant (P <0.05). Conclusion ACE / AGT / e NOS is not a susceptible gene in patients with Uygur in Xinjiang, but related to the progress of IMN.